Changes in posterior capsule opacification after poly(methyl methacrylate), silicone, and acrylic intraocular lens implantation

Purpose: To prospectively evaluate the progression of posterior capsule opa cification (PCO) after poly(methyl methacrylate) (PMMA), silicone, and acry lic intraocular lens (IOL) implantation. Setting: Hayashi Eye Hospital, Fukuoka, Japan. Methods: Three hundred eyes of 300 patients scheduled to have IOL implantat ion were initially randomized into 3 groups based on IOL type: PMMA, silico ne, or acrylic. Of the 300 eyes, 269 completed the follow-up. The PCO densi ty in these eyes was measured 1 week and 3, 6, 12, 18, and 24 months postop eratively using special computer software developed for the Scheimpflug vid eophotography system. Visual acuity and the incidence of neodymium: YAG (Nd :YAG) laser capsulotomy were also examined. Results: Three months postoperatively and later, the mean PCO value in the PMMA group increased significantly (P<.0001); the increase in the silicone and acrylic groups was not significant. The PCO value in the PMMA group was significantly greater than in the silicone or acrylic group (P<.0001). The PCO value in the acrylic group was slightly less than in the silicone grou p at 18 and 24 months, but the difference was marginal. The survival rate n ot requiring Nd:YAG capsulotomy was least in the PMMA group, followed by th e silicone and acrylic groups in that order (P<.0001). The mean logMAR visu al acuity in the PMMA group increased postoperatively and was worse than in the silicone or acrylic group. Conclusions The degree of PCO after PMMA IOL implantation progressed signif icantly with time, while the progression after silicone and acrylic IOL imp lantation was slight. Therefore, PCO in eyes with a PMMA IOL was significan tly more extensive than in those with a silicone or acrylic IOL and resulte d in marked impairment of visual acuity, J Cataract Refract Surg 2001; 27:8 17-824 (C) 2001 ASCRS and ESCRS.