OBJECTIVE: To investigate the effect of AcrySof intraocular lenses (IOLs) on the development of posterior capsule opacification (PCO) compared with silicone or polymethyl methacrylate (PMMA) IOLs for patients with senile cataracts. DESIGN: Meta-analysis of randomized controlled trials (RCTs). PARTICIPANTS: Patient data from previously reported RCTs. METHODS: A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify RCTs comparing AcrySof with silicone or PMMA IOLs in patients with senile cataract. A meta-analysis was performed on the results of RCTs. MAIN OUTCOME MEASURES: Posterior capsule opacification score, neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy rate, and best-corrected visual acuity (BCVA) of 0.5 or better after cataract surgery. RESULTS: In total, 10 RCTs involving 1202 eyes with senile cataract were included in this meta-analysis. The results suggested that AcrySof had lower PCO scores than round-edged silicone IOLs (standard mean difference [SMD], -0.25; 95% confidence interval [CI], -0.42 to -0.08; P = 0.003) and a somewhat higher PCO score than sharp-edged silicone IOLs (SMD, 0.48; 95% CI, 0.29-0.68; P<0.00001). AcrySof had a lower Nd:YAG capsulotomy rate than round-edged silicone IOLs (odds ratio [OR], 0.29; 95% CI, 0.14-0.62; P = 0.001) and did not differ from sharp-edged IOLs (OR, 1.72; 95% CI, 0.23-13.13; P = 0.60). AcrySof had a lower PCO score (SMD, -1.07; 95% CI, -1.29 to -0.85; P<0.00001) and a lower Nd:YAG capsulotomy rate (OR, 0.09; 95% CI, 0.04-0.20; P<0.00001) than round-edged PMMA IOLs. Furthermore, there was no significant difference in BCVA between AcrySof and round-edged silicone IOLs (OR, 2.28; 95% CI, 0.66-7.82; P = 0.19) or PMMA IOLs (OR, 3.20; 95% CI, 0.78-13.16; P = 0.11). CONCLUSIONS: AcrySof and sharp-edged silicone IOLs are similarly effective in inhibition of PCO after cataract surgery. In patients implanted with the AcrySof lens, significantly less PCO developed than in those who had round-edged silicone or PMMA IOLs. The results of this meta-analysis support the theory that a major factor in preventing PCO development is a sharp-edged IOL design.
OBJECTIVE: To investigate the effect of AcrySof intraocular lenses (IOLs) on the development of posterior capsule opacification (PCO) compared with silicone or polymethyl methacrylate (PMMA) IOLs for patients with senile cataracts. DESIGN: Meta-analysis of randomized controlled trials (RCTs). PARTICIPANTS: Patient data from previously reported RCTs. METHODS: A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify RCTs comparing AcrySof with silicone or PMMA IOLs in patients with senile cataract. A meta-analysis was performed on the results of RCTs. MAIN OUTCOME MEASURES: Posterior capsule opacification score, neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy rate, and best-corrected visual acuity (BCVA) of 0.5 or better after cataract surgery. RESULTS: In total, 10 RCTs involving 1202 eyes with senile cataract were included in this meta-analysis. The results suggested that AcrySof had lower PCO scores than round-edged silicone IOLs (standard mean difference [SMD], -0.25; 95% confidence interval [CI], -0.42 to -0.08; P = 0.003) and a somewhat higher PCO score than sharp-edged silicone IOLs (SMD, 0.48; 95% CI, 0.29-0.68; P<0.00001). AcrySof had a lower Nd:YAG capsulotomy rate than round-edged silicone IOLs (odds ratio [OR], 0.29; 95% CI, 0.14-0.62; P = 0.001) and did not differ from sharp-edged IOLs (OR, 1.72; 95% CI, 0.23-13.13; P = 0.60). AcrySof had a lower PCO score (SMD, -1.07; 95% CI, -1.29 to -0.85; P<0.00001) and a lower Nd:YAG capsulotomy rate (OR, 0.09; 95% CI, 0.04-0.20; P<0.00001) than round-edged PMMA IOLs. Furthermore, there was no significant difference in BCVA between AcrySof and round-edged silicone IOLs (OR, 2.28; 95% CI, 0.66-7.82; P = 0.19) or PMMA IOLs (OR, 3.20; 95% CI, 0.78-13.16; P = 0.11). CONCLUSIONS: AcrySof and sharp-edged silicone IOLs are similarly effective in inhibition of PCO after cataract surgery. In patients implanted with the AcrySof lens, significantly less PCO developed than in those who had round-edged silicone or PMMA IOLs. The results of this meta-analysis support the theory that a major factor in preventing PCO development is a sharp-edged IOL design.
Authors: Asieh Golozar; Yujiang Chen; Kristina Lindsley; Benjamin Rouse; David C Musch; Flora Lum; Barbara S Hawkins; Tianjing Li Journal: JAMA Ophthalmol Date: 2018-05-01 Impact factor: 7.389