The effect of intraocular lens material and postoperative therapy on the posterior capsule opacification development after the senile cataract surgery

Abstract

Introduction/Objective The most frequent postoperative complication of a successfully performed phacoemulsification cataract surgery is the development of posterior capsule opacification (PCO). It is caused by the proliferation and migration of the remaining residual epithelial cells. The objective of this study was to investigate the influence of two different intraocular lenses and two different anti-inflammatory drugs on the development of PCO in one-year follow-up period. Methods Investigation included 120 patients (120 eyes), equally divided into four groups. The first two groups included patients who used non-steroid anti-inflammatory drug (NSAID) postoperatively, while the other groups had corticosteroid therapy. The first and third group got hydrophilic intraocular lenses (IOL), the second and fourth group had hydrophobic IOL. Software program EPCO 2000 was used for the analysis of PCO. Student's t-test, Wilcoxon test, and ANOVA were used for data analysis and p < 0.05 value was accepted as statistically significant. Results After the first three postoperative months, patients from NSAID groups had mean PCO score 0.25 ± 0.03, which was statistically significant higher (p = 0.042) comparing to corticosteroid groups. At the end of the investigation, the best result in PCO preventing was seen in the group of patients with hydrophobic IOL and corticosteroid therapy, with the mean PCO score of 0.47 ± 0.08. Conclusion This study has revealed that IOL made of acrylic hydrophobic material seemed to be the right choice when choosing intraocular lens to prevent PCO development. On the other hand, NSAID and corticosteroid therapy have showed similar results in preventing postoperative intraocular inflammation. This fact can be very useful in situations when corticosteroids must be used with great caution.

The Influence of Inflammation in Posterior Capsule Opacification Development

“…This procedure, although routine, is not completely risk-free and can have numerous complications. Therefore, investigators agree that the best treatment of PCO is its prevention (28,29).…”

“…IL 1 acts on LECs causing their proliferation and collagen synthesis (22). Under the action of interleukin 1, prostaglandin E2 is also synthesized, which additionally intensifies inflammation (29). This can be used in clinical practice to reduce the development of PCO by the use of cyclooxygenase blockers.…”