Square-edge polymethylmethacrylate intraocular lens design for reducing posterior capsule opacification following paediatric cataract surgery: initial experience.

PURPOSE: To compare the incidence and severity of development of posterior capsule opacification (PCO) following implantation of square-edged polymethylmethacrylate (PMMA) or hydrophobic acrylic intraocular lenses (IOLs) following paediatric cataract surgery. DESIGN: Prospective, consecutive, interventional, comparative, randomized and cross-sectional study of 40 eyes of 32 children aged between 4 and 12 years who underwent phacoemulsification and posterior chamber IOL implantation. METHODS: The patients were randomized into two groups of 20 eyes each. Group 1 eyes received a square-edge hydrophobic acrylic IOL (Acrysof SA 60 AT, Alcon Surgical, Fort Worth, Texas), and Group 2 eyes received a square-edge single-piece PMMA lens (Aurolab SQ 3600 Aurolab IOL Division, Madurai, India) in the capsular bag. No eye underwent a primary posterior capsulotomy. The PCO density was evaluated on slitlamp retroillumination photographs by using POCOman software at 3, 6, 9 and 12 months post surgery. RESULTS: The average percentage PCO on POCOman analysis was 51.23 for Group 1 and 49.49 for Group 2 (P = 0.09), and the average PCO severity grade was 1.34 in Group 1 and 1.12 in Group 2 (P = 0.08). Visual axis remained clear in 14 of 20 eyes with the acrylic lens as compared with 13 of 20 eyes with the PMMA lens. (P = 0.32). CONCLUSIONS: Square-edge PMMA IOLs offer a significant cost advantage over acrylic lenses at similar rates of PCO formation following paediatric cataract surgery, which is of significant value in developing countries.

Duke Scholars

Author Dilraj Singh Grewal Ophthalmology, Vitreoretinal Diseases & Surgery