Vock Lorenz, Crnej Alja, Findl Oliver, Neumayer Thomas, Buehl Wolf, Sacu Stefan, Rainer Georg, Menapace Rupert
Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Am J Ophthalmol. 2009 Apr;147(4):683-690.e2. doi: 10.1016/j.ajo.2008.11.006. Epub 2009 Feb 8.
To compare posterior capsule opacification (PCO) between 2 three-piece intraocular lenses (IOLs) both with sharp-optic edges and open loop haptics, one made of silicone and the other made of hydrophobic acrylate, 6 years after surgery.
Randomized, controlled, patient- and examiner-masked trial with intra-patient comparison.
One hundred and six eyes in 53 patients were included initially. Forty-four eyes of 22 patients with age-related bilateral cataract were available for the 6 years follow-up. Each patient had standard cataract surgery and randomly received a silicone (CeeOn 911A; AMO, Santa Ana, California, USA) or hydrophobic acrylic (AcrySof MA60BM; Alcon, Fort Worth, Texas, USA) IOL in the first eye, the other type of IOL in the fellow eye. Follow-up examinations were at 1, 3, and 6 years after surgery. The intensity of posterior capsule opacification (PCO) was assessed using digital retro-illuminated photos and the "automated quantification of after-cataract" (AQUA) software. Neodymium-yttrium-aluminum-garnet-laser capsulotomies (YAG-LC) performed were noted.
Six years after surgery, the AQUA scores were 2.3 +/- 1.4 for the silicone and 3.8 +/- 2.0 for the acrylic IOLs (P = .0016). The acrylic IOL eyes also had a significant increase in AQUA score from the 3-year to the 6-year follow-up. YAG-LC were performed in 2 silicone and 6 acrylic IOLs (P = .01).
An angulated three-piece hydrophobic acrylic IOL had more PCO 6 years after surgery than a silicone IOL of otherwise similar design. Apart from an optic material effect, differences in haptic design and the degree of optic edge sharpness may play a role.
比较两种三片式人工晶状体（IOL）术后6年的后囊膜混浊（PCO）情况，这两种人工晶状体均具有锐利的光学边缘和开放襻，一种由硅酮制成，另一种由疏水性丙烯酸酯制成。
随机、对照、患者及检查者双盲试验，采用患者自身对照。
最初纳入53例患者的106只眼。22例年龄相关性双侧白内障患者的44只眼进行了6年随访。每位患者均接受标准白内障手术，第一眼随机植入硅酮人工晶状体（CeeOn 911A；美国眼力健公司，加利福尼亚州圣安娜）或疏水性丙烯酸人工晶状体（AcrySof MA60BM；美国爱尔康公司，得克萨斯州沃思堡），另一只眼植入另一种类型的人工晶状体。术后1年、3年和6年进行随访检查。使用数字后照法照片和“后发性白内障自动定量”（AQUA）软件评估后囊膜混浊（PCO）的程度。记录钕钇铝石榴石激光晶状体后囊切开术（YAG-LC）的实施情况。
术后6年，硅酮人工晶状体的AQUA评分为2.3±1.4，丙烯酸人工晶状体为3.8±2.0（P = 0.0016）。丙烯酸人工晶状体眼的AQUA评分在3年至6年随访期间也有显著增加。2只植入硅酮人工晶状体和6只植入丙烯酸人工晶状体的眼睛进行了YAG-LC（P = 0.01）。
术后6年，有角度的三片式疏水性丙烯酸人工晶状体比设计类似的硅酮人工晶状体出现更多的PCO。除了光学材料的影响外，襻设计和光学边缘锐利程度的差异可能也起了作用。
