Posterior capsular opacification in phacotrabeculectomy - A long-term comparative study of silicone versus acrylic intraocular lens

Purpose: To investigate the long-term outcomes of silicone versus acrylic i ntraocular lens (IOL) implantation in phacotrabeculectomy (PT) with special emphasis on posterior capsular opacification. Design: Long-term follow-up on prior I-year prospective, randomized study. Participants: A total of 200 eyes of 200 consecutive primary open-angle gla ucoma patients who had undergone primary PT with capsular bag implantation of either a silicone IOL (102 eyes) or an acrylic IOL (98 eyes) according t o the initial short-term prospective, randomized study protocol. Intervention: The study eyes underwent primary trabeculectomy, phacoemulsif ication, and posterior chamber IOL implantation. Adjunctive mitomycin C was used selectively, primarily in patients with one or more risk factors for filtration failure. Main Outcome Measures: Incidence of posterior capsular opacification (PCO), best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of pressure-lowering medications, and filtration success rates, defined as ma intenance of target IOP while on one (criteria 1) or zero (criteria 2) pres sure-lowering medications without further surgical intervention. Results: At 3-year follow-up, the PCO rate and BCVA did not differ signific antly between the two groups (P > 0.05 for both). In addition, there were n o significant differences in IOP, number of medications, and filtration suc cess rate between the two groups (P > 0.05 for each). Conclusions: There were no significant long-term differences between the si licone and acrylic IOL groups in PCO, BCVA, IOP, number of medications, and success of filtration surgery after PT. Both groups attained significant i mprovement in BCVA and IOP control after surgery. Ophthalmology 2000; 107:1 868-1874 (C) 2000 by the American Academy of Ophthalmology.