Wr. Meacock et Dj. Spalton, Effect of intraocular lens haptic compressibility on the posterior lens capsule after cataract surgery, J CAT REF S, 27(9), 2001, pp. 1366-1371
Purpose: To evaluate the effect of intraocular lens (IOL) haptic compressib
ility on the posterior capsule after cataract surgery.
Setting: Teaching hospital, London, United Kingdom.
Methods: In this randomized prospective study, 60 patients had standardized
phacoemulsification with in-the-bag placement of a poly(methyl methacrylat
e) (PMMA) (Storz P497UV or hydrogel (Storz Hydroview H60M) IOL. Both IOLs h
ad PMMA haptics of identical configuration and length. The IOL haptic compr
essibility was measured in air and then during incubation in saline at 37 d
egreesC over 1 month. Digital retroillumination imaging was performed 1, 7,
28, 90, 180, 360, and 720 days postoperatively. The presence and duration
of postoperative capsule folds were recorded and correlated with the haptic
compressibility measurements, lens epithelial cell (LEC) growth patterns o
n the posterior capsule at 6 months, and the extent of posterior capsule op
acification.
Results: On the first postoperative day, 21 patients (88%) in the Hydroview
group had posterior capsule folds that persisted in 12 patients (50%) for
2 years. Nineteen patients (68%) in the PMMA group had folds at day 1 (P =
.01), with 1 patient (3%) still having folds at 1 month (P = .0002) and no
patient having folds at 3 months. At 6 months, 11 patients (46%) in the Hyd
roview group and no patient in the PMMA group had LEC growth in the directi
on of the folds, The PMMA IOLs showed a greater decrease in haptic compress
ibility during incubation.
Conclusions: Haptic compressibility should be an important consideration in
IOL design. The results suggest that to avoid posterior capsule folds, the
compressibility should be less than 2.5 mN. (C) 2001 ASCRS and ESCRS.