Randomized Fellow-Eye Controlled Study of Posterior

Capsule Opacification with Acrylic Asphereic and Spherical IOL

Models

Mayank A. Nanavaty, DO, MRCOphth, MRCS(Ed)

David J. Spalton, FRCP, FRCS, FRCOphth

James Boyce. PhD St. Thomas’ Hospital,

London

MAN: Travel funded by Bausch & Lomb. DJS, JM: No financial interest

DJS & JB were consultants to Alcon Laboratories, Texas, USA. MAN: No financial interests in any product or procedure.This project was supported by grant from Alcon Laboratories

Optic sphericity Aspheric Spheric

Design Single piece, posterior aspheric surface

Single piece

Optic diameter 6 mm 6 mm

Over all size 13 mm 13 mm

Material Hydrophobic acrylic Hydrophobic acrylic

AcrySof IQ AcrySof Natural

The posterior aspheric design of this IOL makes it interesting to study it’s influence on PCO

Background

To compare post-operative

• Visual acuity

• Posterior capsular opacification (PCO)

• Rhexis area

after implantation of AcrySof IQ and AcrySof Natural IOLs

Aims

Methods

• Prospective randomised fellow eye comparison

• Normal eyes with bilateral cataracts

• Single Surgeon, standardised phaco technique

• Follow-up at 1m, 3m, 6m, 1yr, 2yrs

Follow-up data

At each visit:

• 100% & 9% LogMAR BCVA

• PCO and rhexis area measured with

retroillumination images and POCO software

Results

• 94 eyes of 47 patients were enrolled

• Average age 76 yrs +/- 7.7 (60-91yrs)• Follow-up at 1m = 94 eyes of 47 patients

3m & 6m = 88 eyes of 44 patients

12m = 84 eyes of 42 patients

24m = 82 eyes of 41 patients

• There was no significant difference in capsulorhexis area at any follow up visits between the two groups (p = ns)

9% BCVA

Best corrected visual acuity

P=0.03

1 63

Months

*

100% BCVA

p = ns p = ns

AcrySof IQ AcrySof Natural

Mean PCO score

1 63 12 24

Months

P < 0.05 at all time points

* **

**

AcrySof IQ

AcrySof Natural

p = ns

OS AcrySof IQ

OD AcrySof Natural

1 m 3 m 6 m 1 y

Pt OSP

2 y

OS AcrySof IQ

OD AcrySof Natural

1 m 3 m 6 m 1 y

Pt ILA

2 y

Optic edge thickness

197.7 198.7

AcrySof IQ AcrySof Natural

Not a very big difference in edge thickness!Nanavaty MA, Spalton DJ, et al. J Cataract Refract Surg 2008

Conclusion

• Best corrected 100% and 9% LogMAR visual acuity is not

different between AcrySof IQ and AcrySof Natural

• PCO is not significantly different between the two IOLs at 2

years

• Posterior asphericity of AcrySof IQ does not influence the

PCO outcomes