Effect of four different intraocular

lenses on posterior
capsule opacification

Muhammad Alif Rio Yudhatama

Kepaniteraan Klinik Ilmu Kesehatan
Mata
BKIM Semarang
 Introduction
Cataract Surgery

Posterior Capsule
Material of IOLs Surgery Method
Opasification

Laser Nd:YAG
 Subject and Methods

Cohort with a long follow-up time

Design

Ankara University Faculty of Medicine,

Place Department of Ophthalmology

January 2000 and January 2008.

Time
 Subject and Methods

Data was collected retrospectively for 4970 consecutive eyes of 4013 patients
Study
Population

patients with senile cataract who underwent uncomplicated phacoemulsification

surgery and IOL implantation performed by one surgeon (Karel F)
Inclusion

concomitant ocular pathologies (uveitis or history of uveitis high myopia (>S-6D )

previous trauma or had suffered any intra operative complication (capsulorhexis
rim tear, zonular rupture, posterior capsule rupture with or without vitreous loss
Exclusion or the usage of the capsule tension ring)
Devided into 4 groups based on 4 different IOLs

Group 1 :AcrySof SN60AT (Alcon Laboratories, Inc., Fort

Worth, TX, USA), 1-piece acrylic hydrophobic IOL with a 6.0
mm optic diameter, a 13.0 mm overall diameter and acrylic
haptics angled at 0, was implanted in 1399 eyes of 1014
patients.
Group 2 : AcrySof MA30BA (Alcon Laboratories, Inc., Fort
Worth, TX, USA), a 3-piece acrylic hydrophobic IOL with a
5.5 mm optic diameter, a 12.5 mm overall diameter and
poly methyl metahacrylate (PMMA) haptics angled at 5,
was implanted in 1509 eyes of 1242 patients.
 Group 3 : AcrySof MA60BM (Alcon Laboratories, Inc.,
Fort Worth, TX, USA), a 3-piece acrylic hydrophobic
IOL with a 6.0 mm optic diameter, a 13.0 mm overall
diameter and PMMA haptics angled at 10, was
implanted in 1501 eyes of 1324 patients.
Group 4 : Aqua-SenseTM III (Aaren Scientific
Inc.,Ontario, USA) a 3-piece acrylic hydrophilic IOL
with a 6.0 mm optic diameter, a 12.5 mm overall
diameter and acrylic haptics angled at 5, was
implanted in 561 eyes of 433patients.
 Surgeon
(Karel F)
Ankara University Faculty of Medicine,
Department of Ophthalmology between
January 2000 and January 2008
 Post operative treatment

Dexamethason topical 0,1%

Ciprofloxasin topical
5 time daily for 1mo
 Statistical analysis
Major outcome PCO development associated with each IOL

The differences between Were compared using a Z test

groups

statistical significance of assessed using the Chi-square test. A value P less

differences in frequencies than 0.05 was considered statisticallysignificant.

Analysis SPSS 13.0 software SPSS Inc., Chicago, USA)

 RESULT
Mean of PCO requiring Mean time PCO
Sign. Sig.
age Nd:YAG laser/% developement
Group 1 67.909.55 41 eyes/2.93% 0,74 13.2110.02mo 0,001
66.9010.7
Group 2 41 eyes/2.72% 0,71 33.1125.06mo
3
Group 3 69.338.44 45 eyes/3.00% 0,71 22.2516.02mo

Group 4 70.039.56 26 eyes4.63% 0,015 39.9115.52mo 0,001

 DISCUSSION
The incidence of PCO is affected by many factors.
The development of modern foldable IOLs with square-edged optics has greatly
reduced the incidence of PCO following cataract surgery.

The sharp optic edge, now known to be a major inhibitory factor for PCO
recent development
studies

The clinical introduction of 1-piece acrylic hydrophobic IOLs with some differences in
optic and haptic design was expected to be associated with a different rate of PCO
development compared with 3-piece acrylic hydrophobic IOLs.
Camparasion
1y after surgery, 1-piece acrylic IOLs are associated with slightly more regeneratory
of IOLs PCO than 3-piece acrylic IOLs made from the same material.
material the modification of an IOL from a 3-piece to a 1-piece haptic design caused no
significant change in the development of PCO.
 hydrophilic acrylic lenses provide a suitable
environment for lens epithelial cells migration
IOLs because of the hydrophilic surface properties.
causing
PCO Previous studies have reported that
hydrophobic IOLs are associated with lower
rates of PCO than hydrophilic IOLs

The According to our results, eyes with acrylic

needed
of
hydrophobic optic IOLs were more likely to
Nd:YAG require Nd:YAG laser capsulotomy than eyes
laser with acrylic hydropholic optic IOLs.
 Conclusion

A higher percentage of eyes with

hydrophilic acrylic IOLs developed
PCO than eyes with acrylic
hydrophobic IOLs.
summar no significant difference in the long-
term PCO rate of a1- or 3-piece
y hapticlens design.
Eyes with acrylic hydrophilic IOLs did
not require an Nd:YAG laser
capsulotomy as soon as eyes with
acrylic hydrophobic IOLs.
 CRITICAL
APPRAISAL
Title Abstract
Consist of less than 10 Informative. There are
words background, methods,
Describe the main results, conclusion, there
contents of study are keyword, and < 250
words
Contents
Inclusion and exclusion
criteria are mentioned
There is time and place
of this study
But this study is not RCT
 PICO Analysis

P I C O
acrylic
hydrophilic
Patient With Neodymium:y IOLs were
ttrium- impact of 4 more likely to
Posterior
aluminum- foldable develop PCO
Capsule garnet sharp-edged than
Opacification (Nd:YAG) laser
IOLs those with
(PCO) capsulotomy acrylic
hydrophobic
IOLs.
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3. Daftar penulis sesuai +
aturan jurnal
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2. Alasan dilakukan penelitian +

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tentang hasil
 Pembahasan, Kesimpulan, Daftar
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No. Kriteria Ya (+) atau Tidak (-)
1. Pembahasan dan kesimpulan terpisah -
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3. Pembahasan mengacu dari penelitian +
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8. Saran penelitian -
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 Apakah hasil
penelitian tersebut
Apakah penelitian ini
mungkin untuk
penting ?
diterapkan pada
pasien kita ?
Penting bagi
Tidak bisa,
praktisi
mengingat
kesehatan mata
sebagian besar
untuk mengetahui
pasien kita BPJS
perkembangan
sehingga opsi
tentang pengaruh
untuk jenis lensa
jenis IOLs
yang spesifik
terhadap
terbatas
insidensi PCO