Impact of primary posterior capsulorhexis on regeneratory after-cataract and YAG laser rates with an acrylic micro-incision intraocular lens with plate haptics: 1-year and 3-year results

Acta Ophthalmol. 2019 Dec;97(8):e1130-e1135. doi: 10.1111/aos.14156. Epub 2019 Jun 13.


Purpose: To evaluate the posterior capsule opacification (PCO) and YAG laser capsulotomy (YAG-LCT) rates with a plate-haptic acrylic micro-incision intraocular lens (IOL) and the impact of primary posterior capsulorhexis.

Methods: A total of 97 patients scheduled for immediate sequential bilateral cataract surgery underwent a randomized, prospective intraindividual comparison with the ZEISS Asphina 409MV plate-haptic acrylic IOL with the eyes receiving an additional primary posterior capsulorhexis (PPCR) or not. YAG-LCT and PCO rates were evaluated at 1 and 3 years. Three-year PCO rates were calculated with a 3-scenario method for eyes that underwent YAG-LCT between 1 and 3 years.

Results: A total of 56 patients were seen at 1 year, and 57 at 3 years. For the eyes without and with PPCR, YAG-LCT rates were 14.3% and 0% at 1 year, and 59.7% and 3.5% at 3 years, respectively. Opacification rates at 1 year were 0.55 ± 0.99 and 0.05 ± 0.21 for the central 2-mm optic zone. A total of 42 patients completed both the 1- and 3-year follow-up. Three-year opacification rates for the group without PPCR were 1.99 ± 2.20, 2.26 ± 2.66 and 3.66 ± 3.61 for the central 2-mm zone and 2.57 ± 2.07, 3.13 ± 3.03 and 4.09 ± 3.34 for the 4.5-mm zone for the best, extrapolated and worst-case scenarios, respectively.

Conclusion: The ZEISS Asphina 409MV plate-haptic acrylic IOL exhibited unusually high YAG-LCT and PCO rates with standard in-the-bag implantation. PPCR was safe and effective in preventing central opacification and the need for YAG laser treatment.

Keywords: YAG laser capsulotomy; ZEISS CT Asphina 409MV plate-haptic acrylic micro-incision intraocular lens; posterior capsule opacification; primary posterior capsulorhexis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acrylic Resins*
  • Aged
  • Capsulorhexis / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Therapy / methods*
  • Lasers, Solid-State / therapeutic use*
  • Lens Implantation, Intraocular / methods*
  • Lenses, Intraocular*
  • Male
  • Minimally Invasive Surgical Procedures / methods
  • Posterior Capsule of the Lens / surgery
  • Prospective Studies
  • Prosthesis Design
  • Silicone Elastomers*
  • Time Factors


  • Acrylic Resins
  • Silicone Elastomers