Influence of optic edge design and anterior capsule polishing on posterior capsule fibrosis

J Cataract Refract Surg. 2004 Mar;30(3):658-62. doi: 10.1016/j.jcrs.2003.07.005.


Purpose: To evaluate the role of posterior optic edge design and the effect of anterior capsule polishing on peripheral fibrotic posterior capsule opacification (PCO).

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

Methods: This randomized prospective study comprised 144 eyes of 72 patients with bilateral age-related cataract. Each patient had standardized cataract surgery in both eyes by the same surgeon. Group 1 (46 patients) received a round-edged hydrophobic acrylic IOL (AMO Sensar AR40) in 1 eye and a sharp-edged hydrophobic acrylic IOL (AMO Sensar OptiEdge AR40e) in the other eye. Group 2 (26 patients) received a silicone IOL (Pharmacia CeeOn 911A) with a truncated optic in both eyes. In this group, the anterior capsule was extensively polished in 1 eye and was left unpolished in the other eye. Digital slitlamp photographs were taken 1 year postoperatively using a standardized photographic technique for fibrotic PCO. The intensity of PCO was subjectively graded (score 0 to 4) by 2 masked examiners.

Results: Subjective PCO scores correlated well between the 2 examiners (r = 0.88). In Group 1, the mean PCO score was 0.26 for the OptiEdge AR40e IOL and 0.90 for the AR40 IOL (P<.01). In Group 2, the mean PCO score was 0.24 in eyes with a polished capsule and 0.17 in eyes in which the capsule was not polished (P =.31).

Conclusions: The sharp-edged OptiEdge AR40e IOL led to significantly less peripheral fibrotic PCO 1 year postoperatively than the round-edged AR40 IOL. In eyes with the sharp-edged silicone 911A IOL, anterior capsule polishing caused no significant difference in fibrotic PCO.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acrylic Resins
  • Aged
  • Biocompatible Materials*
  • Cataract / etiology*
  • Fibrosis
  • Humans
  • Image Processing, Computer-Assisted
  • Lens Capsule, Crystalline / pathology*
  • Lens Capsule, Crystalline / surgery*
  • Lens Implantation, Intraocular / methods
  • Lenses, Intraocular*
  • Phacoemulsification / methods
  • Postoperative Complications*
  • Prospective Studies
  • Prosthesis Design
  • Silicone Elastomers


  • Acrylic Resins
  • Biocompatible Materials
  • Silicone Elastomers