Acrylic, silicone IOLs show similar PCO after 12 years

This prospective study found that after 12 years there was no significant difference in PCO or overall survival without capsulotomy between a sharp-edged acrylic IOL and a round-edged silicone IOL.

This study conducted at a hospital in Stockholm, Sweden, turns our knowledge on its ear! Square-edged hydrophobic acrylic IOLs are only better than round-edged silicone IOLs for the first three years. If PCO didn’t occur by six years, the silicone stopped opacifying while the acrylic kept going.

Patients undergoing unilateral standard phacoemulsification were randomized to implantation of a round-edged heparin-surface-modified poly methyl methacrylate IOL, a round-edged silicone IOL, or a sharp-edged hydrophobic acrylic IOL. The initial study population included 180 patients but due to death and severe illness the final statistical analysis was based on 106 patients.

After 12 years, there was no significant difference in PCO severity between any of IOLs. The heparinIOL had a significantly higher PCO fraction than the silicone IOL (P < 0.05), but not more than the acrylic IOL.

The silicone IOL had a higher median capsulotomy-free survival (> 150 months) than the acrylic IOL (108 months) and the heparin IOL (53 months). Overall survival without Nd:YAG capsulotomy did not differ between the acrylic and silicone IOLs or between the silicone and heparin IOLs; however, overall survival was significantly better with the acrylic IOL than with the heparin IOL (P < 0.001).