Study finds similar PCO rates at 2 years for one- and three-piece IOLs

Patients implanted with either a one-piece or a three-piece sharp-edge hydrophobic acrylic IOL had similarly low rates of posterior capsular opacification at 2 years follow-up, a prospective study found. However, the one-piece IOL was associated with a higher incidence of capsular folds, the study authors said.

Reda Zemaitiene, MD, PhD, and colleagues in Kaunas, Lithuania, compared rates of anterior and posterior capsule opacification (PCO) between patients randomly assigned to receive one of two AcrySof IOLs (Alcon). The study included 37 patients implanted with the three-piece MA30BA and 37 patients implanted with the one-piece SA30AL.

Both lenses feature a biconvex, square-edged, 5.5-mm hydrophobic acrylic optic and a 12.5 mm overall diameter. The three-piece lens has PMMA haptics angled at 5°; while the one-piece lens has no haptic angulation, according to the study.

The researchers found that patients who received the one-piece IOL had more capsulorrhexis rim area fibrosis in the anterior chamber at 6 months and 1 year, although the difference was not statistically significant. This patient group experienced a significantly higher incidence of capsular folds at all follow-up points.

Capsular folds were seen in 27.03% of the three-piece IOL group and 43.24% of the one-piece IOL group at 1 day postop, which decreased to 6.06% of the three-piece group and 19.35% of the one-piece group at 2 years, according to the study.

Patients implanted with the three-piece IOL had significantly more PCO up to 1 year postop, particularly around the entire IOL optic and in the central 3-mm optic zone.

"However, 2 years after surgery, PCO values in both groups were no longer different," the authors said.

Both groups had similar visual acuities throughout the follow-up period and no patients required Nd:YAG laser capsulotomies, they noted.

The study is published in the May issue of the British Journal of Ophthalmology.