Lens design critical in preventing PCO

Square-edged design and the sharpness of the posterior edge key to PCO

Dermot McGrath

Posted: Monday, May 13, 2019

Gilles Lesieur MD

Intraocular lens design was found to be the key determining factor in the rate of posterior capsular opacification (PCO) development in a large series of microincision cataract surgery (MICS) lenses, according to a study.

At the meeting of the French Society of Ophthalmology, Gilles Lesieur MD presented the analysis of a large series of 6,500 lenses with up to eight years’ follow-up.

“Although we know that PCO is multifactorial and that surgical technique, IOL biomaterial and patient characteristics may all play a role, the key factors in its development seem to be the presence of a square-edged design and the sharpness of the posterior edge of the optic,” he said.

Dr Lesieur’s retrospective analysis included seven different MICS lens types: CT Asphina (Zeiss), Micro AY, MicroSlim and Micropure (PhysIOL), Akreos MICS (Bausch and Lomb), Incise (Bausch and Lomb) and Synthesis (Cutting Edge).

The Akreos MICS was found to have the highest rate of Nd: YAG laser capsulotomy over the eight-year follow-up period. “This is perhaps due to the design of the lens, with excessive polishing of the optic edges presenting less of a barrier to lens epithelial cell migration,” he said.

The MicroSlim, with its uninterrupted square-edge optic, recorded the lowest rate of PCO, noted Dr Lesieur, while the CT Asphina’s plate haptic design with a square edge only delayed PCO for the first three years with Nd:Yag rates increasing thereafter.