Hydrophobic acrylic IOL material delays but does not prevent PCO onset

May 15, 2008

The rate of posterior capsule opacification (PCO) associated with hydrophobic acrylic IOLs (AcrySof, Alcon Laboratories) is lower than the rate seen with other lens materials for 3 to 5 years after implantation, but after that time, the rate approximates that seen with other lens materials, according to results of an ongoing prospective, consecutive-case study of 5,500 eye-bank eyes. The finding could affect IOL selection decisions, especially for the pediatric patient population, in whom a high rate of PCO typically is seen, and for patients in developing countries, where access to Nd:YAG lasers to address PCO is limited.

Key Points

Chicago-Although it is well established that IOLs made of hydrophobic acrylic are associated with a lower incidence of posterior capsule opacification (PCO), new long-term data demonstrate that the material delays but does not prevent the onset of the complication, said David J. Apple, MD, here at the annual meeting of the American Society of Cataract and Refractive Surgery.

Dr. Apple, who recently transferred his office and laboratory to Sullivans Island, SC, from Salt Lake City, presented the results of an ongoing prospective, consecutive-case study of 5,500 eye-bank eyes. He predicted that its findings might affect IOL selection decisions for some patients, including children and those in developing countries.

Hydrophobic acrylic IOLs (AcrySof, Alcon Laboratories) have been considered the lens of choice for pediatric patients because of high rate of PCO typically seen in this population and for patients in developing nations because of the lack of access to Nd:YAG lasers to address PCO when it occurs, Dr. Apple said.

As the study progressed and data were accumulated, the investigators divided the eyes into two groups, those examined approximately 3 to 5 years postoperatively and those examined about 7 to 15 years postoperatively.

The researchers separated lens styles by manufacturer and model number. They used the Miyake-Apple posterior video/photographic technique to examine the IOLs from behind. "This view provides a broad field to examine the entire IOL and surrounding structures," Dr. Apple said in an interview with Ophthalmology Times.

"We wanted to see how the biomaterials performed," he added. To date, the researchers have concentrated on the hydrophobic acrylic IOLs because of the known low PCO rates that had been seen with the material over the short term, he said, adding that, as the study continues, it will concentrate on silicone, PMMA, and hydrophilic lenses.