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Intra-individual comparative study of Nd:YAG-laser incidence with two hydrophilic MICS IOLs, one with sharp posterior edge.

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First Author: A.Rygaard SWEDEN

Co Author(s):    B. Johansson                    

Abstract Details

Purpose:

To investigate Nd:YAG-laser incidence due to visually disturbing posterior capsular opacification (PCO) occurring within 5 years after phacoemulsification in patients implanted with a hydrophilic acrylic Micro-Incision Cataract Surgery (MICS) IOL (MI60, Bausch & Lomb, Rochester, NY USA) in one eye, and a hydrophilic acrylic MICS IOL with sharp posterior edge and modified water content in the contralateral eye (MJ14, Bausch & Lomb, Rochester, NY USA).

Setting:

Academic hospital, 2500000 citizens in uptake area. 2400 cataract operations annually. Only unit offering YAG-laser treatment within uptake area.

Methods:

We searched electronic medical records for cataract operations performed September 9th 2011 to February 6th 2014 to identify patients with both eyes operated during that period, with one eye receiving MI60 IOL and the other eye MJ14 IOL. Cases with peroperative damage to capsule or zonulae were excluded. Dates of Nd:YAG-laser treatment or death within a follow-up period of 5 years (1825 days) were recorded. To test statistical significance we used Chi-square test for cross-sectional observation of outcome at 5 years after surgery and Cox regression model to assess effects of age at surgery and death during follow-up period.

Results:

Eighteen patients were enrolled. In eyes with MI60, 9 (50%) underwent Nd:YAG-laser capsulotomy within 5 years after surgery, whereas none of the 18 eyes with MJ14 did. Two patients died before reaching a 5-year follow-up period for both implanted IOLs, and 2 patients died after 5-year follow-up of the eye with MI60 IOL but did not reach 5-year follow-up for the eye with MJ14 IOL. The difference in Nd:YAG-laser incidence was statistically significant both with Chi-square test as well as with Cox regression, taking into account patient age at surgery as well as date of death.

Conclusions:

In this retrospective intra-individual comparative study, eyes with MICS IOL MJ14 showed absence of visually disturbing PCO demanding Nd:YAG-laser treatment for a period of 5 years after surgery. In contrast, 50% of the eyes with MICS IOL MI60 needed Nd:YAG-laser treatment for visually disturbing PCO within 5 years after surgery. We conclude that the design of the MJ14 MICS IOL, with a modified water content compared with other hydrophilic acrylic IOLs and a sharp posterior optic edge, with clinical as well as statistical significance delays PCO development after phacoemulsification for cataract.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented