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PCO rate similar at 2 years with one-piece, three-piece AcrySof

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PARIS — With 2 years’ follow-up, the posterior capsular opacification performance of the one-piece and three-piece Alcon AcrySof IOLs is equally good, according to a speaker here.

Oliver Findl, MD, and colleagues at the Medical University of Vienna compared the two designs of the Alcon hydrophobic acrylic IOL in a study he presented at the European Society of Cataract and Refractive Surgeons meeting.

Dr. Findl noted that David J. Apple, MD, and others have suggested that the bulky optic-haptic junction of the AcrySof one-piece IOL might provide a platform for proliferation of lens epithelial cells onto the posterior optic surface of the lens, thus defeating the advantage provided by the squared posterior edge around the rest of the optic’s perimeter. Dr. Apple and colleagues have previously shown the ability of the squared 360° posterior optic edge, such as that on the three-piece AcrySof IOL, to minimize PCO.

Dr. Findl said a bilateral, randomized, masked study was designed to compare PCO formation with the two IOL designs. All surgeries in 104 eyes of 52 patients in the study were performed by the same surgeon. Each patient received a one-piece AcrySof in one eye and a three-piece AcrySof in the other. Thirty-four patients completed 2-year follow-up. PCO was graded both by slit-lamp evaluation and with the AQUA automated image analysis system for evaluating PCO.

At 1 year postoperative, Dr. Findl said, the amount of regeneratory PCO based on the AQUA score was statistically significantly higher in the eyes with the one-piece lens. By 2 years postop, however, there was no statistically significant difference in AQUA scores between the two IOL designs, he said. The same was true with the subjective slit-lamp grading, he said, with a slight but significant difference at 1 year but no significant difference at 2 years.

Dr. Findl noted that the PCO scores were low with both IOL styles and that no YAG capsulotomy was needed in either group during the 2 years of follow-up.