Posterior capsule opacification in silicone and hydrophobic acrylic intraocular lenses with sharp-edge optics six years after surgery

Am J Ophthalmol. 2009 Apr;147(4):683-690.e2. doi: 10.1016/j.ajo.2008.11.006. Epub 2009 Feb 8.


Purpose: To compare posterior capsule opacification (PCO) between 2 three-piece intraocular lenses (IOLs) both with sharp-optic edges and open loop haptics, one made of silicone and the other made of hydrophobic acrylate, 6 years after surgery.

Design: Randomized, controlled, patient- and examiner-masked trial with intra-patient comparison.

Methods: One hundred and six eyes in 53 patients were included initially. Forty-four eyes of 22 patients with age-related bilateral cataract were available for the 6 years follow-up. Each patient had standard cataract surgery and randomly received a silicone (CeeOn 911A; AMO, Santa Ana, California, USA) or hydrophobic acrylic (AcrySof MA60BM; Alcon, Fort Worth, Texas, USA) IOL in the first eye, the other type of IOL in the fellow eye. Follow-up examinations were at 1, 3, and 6 years after surgery. The intensity of posterior capsule opacification (PCO) was assessed using digital retro-illuminated photos and the "automated quantification of after-cataract" (AQUA) software. Neodymium-yttrium-aluminum-garnet-laser capsulotomies (YAG-LC) performed were noted.

Results: Six years after surgery, the AQUA scores were 2.3 +/- 1.4 for the silicone and 3.8 +/- 2.0 for the acrylic IOLs (P = .0016). The acrylic IOL eyes also had a significant increase in AQUA score from the 3-year to the 6-year follow-up. YAG-LC were performed in 2 silicone and 6 acrylic IOLs (P = .01).

Conclusions: An angulated three-piece hydrophobic acrylic IOL had more PCO 6 years after surgery than a silicone IOL of otherwise similar design. Apart from an optic material effect, differences in haptic design and the degree of optic edge sharpness may play a role.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acrylic Resins / adverse effects*
  • Aged
  • Cataract / etiology*
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Therapy
  • Lasers, Solid-State / therapeutic use
  • Lens Capsule, Crystalline / pathology*
  • Lens Capsule, Crystalline / surgery
  • Lens Implantation, Intraocular
  • Lenses, Intraocular / adverse effects*
  • Male
  • Phacoemulsification
  • Prosthesis Design*
  • Silicone Elastomers / adverse effects*
  • Visual Acuity


  • Acrylic Resins
  • Silicone Elastomers