After-cataract in adults with primary posterior capsulorhexis: comparison of hydrogel and silicone intraocular lenses with round edges after 2 years

J Cataract Refract Surg. 2003 May;29(5):955-60. doi: 10.1016/s0886-3350(02)01814-x.


Purpose: To evaluate the potential of primary posterior continuous curvilinear capsulorhexis (PCCC) to prevent after-cataract 2 years after surgery and perform a bilateral comparison of 2 intraocular lens (IOL) materials, silicone and hydrogel.

Setting: Department of Ophthalmology, University of Vienna, Medical School, Vienna, Austria.

Methods: In this randomized patient- and examiner-masked study, 37 patients (74 eyes) with age-related cataract had bilateral small-incision cataract surgery with PCCC. Randomly, 1 eye received a hydrogel IOL and the contralateral eye, a silicone IOL. Both IOLs had open-loop haptics and a round-edged optic. Standardized digital retroillumination photographs were taken 1 day and 1, 6, 12, and 24 months after surgery to evaluate development of after-cataract on the anterior and posterior capsules by subjective grading. Opacification of the PCCC area was also objectively evaluated using new software.

Results: Twenty-nine patients (58 eyes) completed the 2-year follow-up. Partial closure with ongrowth at the edge of the PCCC was found in 55% in the hydrogel group and 28% in the silicone group. Total closure of the PCCC was observed in 3 eyes, 2 in the hydrogel group and 1 in the silicone group.

Conclusion: Ongrowth onto the PCCC area was dependent on IOL material. Because of less ongrowth and more fibrotic after-cataract with silicone IOLs, the efficacy of the PCCC was higher in this group.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Capsulorhexis / methods
  • Cataract / diagnosis
  • Cataract / etiology*
  • Cataract / therapy
  • Double-Blind Method
  • Epithelial Cells / pathology
  • Female
  • Humans
  • Hydrogel, Polyethylene Glycol Dimethacrylate*
  • Laser Therapy
  • Lens Capsule, Crystalline / pathology*
  • Lens Capsule, Crystalline / surgery
  • Lens Implantation, Intraocular
  • Lenses, Intraocular / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prospective Studies
  • Prosthesis Design
  • Silicone Elastomers*


  • Silicone Elastomers
  • Hydrogel, Polyethylene Glycol Dimethacrylate