Long-term effect of 1-piece and 3-piece hydrophobic acrylic intraocular lens on posterior capsule opacification: a randomized trial

Ophthalmology. 2007 Sep;114(9):1663-9. doi: 10.1016/j.ophtha.2006.12.016.


Purpose: To compare the intensity of posterior capsule opacification (PCO) between the 1-piece and 3-piece haptic designs of the foldable hydrophobic acrylic AcrySof intraocular lens (IOL) over a 5-year period.

Design: Randomized, prospective, patient- and examiner-masked clinical trial with intraindividual comparison.

Participants: Fifty-two patients with bilateral age-related cataract (104 eyes).

Methods: Each study patient had cataract surgery in both eyes and received a 1-piece AcrySof IOL in 1 eye and a 3-piece AcrySof IOL in the other eye. Follow-up examinations were performed at 1 week, 1 month, 6 months, and 1, 2, and 5 years. Digital retroillumination images were obtained of each eye. The amount of posterior capsule opacification (score range, 0-10) was assessed subjectively at the slit lamp and objectively using automated image analysis software 1, 2, and 5 years after surgery.

Main outcome measure: Posterior capsule opacification score (scale, 0-10).

Results: There was no significant difference between the 1-piece and 3-piece AcrySof IOL in best-corrected visual acuity, overlap of rhexis and IOL, capsular folds, anterior capsule opacification, and posterior capsule opacification (1-piece AcrySof PCO score, 1.7+/-1.7; 3-piece AcrySof PCO score, 1.3+/-1.4; P = 0.30).

Conclusions: Modification of the IOL haptic design of the sharp optic edged AcrySof IOL from a 3-piece to a 1-piece haptic design caused no significant change in PCO intensity and neodymium:yttrium-aluminium-garnet laser treatment rate 5 years after surgery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acrylic Resins*
  • Aged
  • Cataract / etiology*
  • Double-Blind Method
  • Follow-Up Studies
  • Humans
  • Laser Therapy
  • Lens Capsule, Crystalline / pathology*
  • Lens Capsule, Crystalline / surgery
  • Lens Implantation, Intraocular*
  • Lenses, Intraocular*
  • Phacoemulsification
  • Postoperative Complications*
  • Prospective Studies
  • Prosthesis Design
  • Visual Acuity


  • Acrylic Resins