Neodymium : YAG capsulotomy rates following phacoemulsification with implantation of PMMA, silicone, and acrylic intraocular lenses

BACKGROUND AND OBJECTIVE: Posterior capsular opacification (PCO) is the mos t common visually disabling sequela of modern cataract surgery. Methods of reducing its incidence include the development of newer surgical techniques and intraocular lens (IOL) materials and designs. The aim of this study wa s to compare the incidence and time interval of development of PCO, and the requirement of laser capsulotomy in patients implanted with a polymethylme thacrylate (PMMA), silicone, or acrylic IOL. PATIENTS AND METHODS: The data of 340 consecutive patients who underwent ph acoemulsification and implantation of a PMMA, silicone, or acrylic intraocu lar lens were analyzed. The aim of this study was to compare the incidence and time interval of development of PCO, and the requirement of laser capsu lotomy in patients implanted with a PMMA, silicone, or acrylic IOL. RESULTS: The incidence of PCO was found to be significantly less in the acr ylic group (6.5% as compared to 21.74% and 26.6% in the PMMA and silicone g roups, respectively; P = 0.01297 and 0.0039). Most patients (65%) exhibitin g PCO in the PMMA group developed it within the first six months. In the si licone group, development of PCO was delayed. In 60% of patients, it appear ed 18 months after surgery. Neodymium:YAG capsulotomy was required in 45% a nd 60% of patients developing PCO in the PMMA and silicone groups, respecti vely, while it was required in only 1 of the 4 patients developing PCO in t he acrylic group. CONCLUSION: This study indicates that implantation of an acrylic IOL helps reduce the incidence of PCO as well as the need for Nd:YAG capsulotomy. PMM A IOLs require Nd:YAG capsulotomy earlier in the postoperative period as co mpared to silicone IOLs.