Effect of intraocular lenses on preventing posterior capsule opacification

In Brief Purpose: To compare the preventive effect of 4 types of design- and material-matched intraocular lenses (IOLs) on posterior capsule opacification (PCO). Setting: Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan. Methods: After phacoemulsification, 1 of 2 matched IOLs in 3 groups was implanted in 1 eye and the other IOL in the contralateral eye of 4 to 6 rabbits. Three weeks postoperatively, posterior view and histopathological evaluations were performed and the capsular bending effect and amount of PCO evaluated. Results: The capsular bending effect was similar between a sharp-edged acrylic IOL (Sensar® 40e, AMO) and a sharp-edged silicone IOL (ClariFlex®, AMO) and between the Sensar 40e IOL and a sharp-edged acrylic IOL (AcrySof®, Alcon Laboratories). There was no significant difference between IOL types in the amount of PCO. The capsular bend effect was slightly better and the PCO amount slightly less with the ClariFlex IOL than with the round-edged silicone PhacoFlex® II IOL (AMO). Conclusions: There was no substantial difference in PCO prevention between IOLs with sharp posterior optic edges, regardless of the IOL's material composition. The anterior edge design appeared to have no preventive effect. These results confirm that a sharp posterior optic edge is the main factor in preventing PCO. Sensar 40e, ClariFlex, and AcrySof IOLs showed a distinct capsular bend at the sharp optic edge and a similar effect in reducing PCO, whereas the PhacoFlex II IOL with square but blunt edges showed a less sharp bend and had a slightly inferior PCO-reducing effect.