Abstract
Aim: To compare the incidence of Posterior Capsular Opacification (PCO) after implantation of Round Edged Polymethylmethacrylate (PMMA) IOL and Square Edged PMMA IOL in cases of Small Incision Cataract Surgery (SICS) and to select clinically significant cases of PCO for Neodymium-doped Yttrium Aluminum Garnet (Nd: YAG) capsulotomy.
Methods and Materials: A retrospective and comparative study in 500 eyes of 500 patients underwent uncomplicated SICS with Round Edged IOL implantation in group A and Square Edged IOL in group B with a minimal follow up period of 1 year. During this period the best corrected visual acuity and grades of PCO were assessed.
Statistical Analysis: Unpaired t test and Chi square test were used for statistical analysis.
Results: Overall incidence of visually significant PCO was 19.6%,in group A the incidence was 29.6% and in group B it was 9.6%.
Conclusion: This study showed that manual SICS with implantation of Square Edged IOL is a cost effective option for low income groups in rural areas. Square Edged design induces a barrier effect on PCO thereby reducing migration of lens epithelial cells and reducing incidence of PCO.PMMA supports epithelial cell adhesiveness to a lesser extent.
Keywords: Small incision cataract surgery (SICS), posterior capsular opacification (PCO), Round Edged Polymethylmethacrylate (PMMA) IOL, Square Edged Polymethylmethacrylate (PMMA) IOL.
References
- Minassian DC, Mehra V .3.8 million blinded by cataract each year: Projections from the first epidemiological study of incidence of cataract blindness in India.Br J Ophthalmol 1990;74:341-3.
- Mudhol RR, Shetti SA, Dodamani DK. Square edge intra-ocular lens versus conventional round-edge intra-ocular lens in prevention of posterior capsular opacification: A randomized clinical trial.J SciSoc 2016;43:6-10.
- Shailly Raj, Singh Brijesh, Ifsa Sami, Singh Sonali. The square edged IOLS lessen the need of Nd:Yag Capsulotomy : A study in rural population. International Journal of Research in Health Sciences.2015 April - June;3(2):326-330.
- Legler UF, Apple DJ, Assia EI, Bluestein EC , Castaneda VE , Mowbray SL: Inhibition of posterior capsule opacification ; the effect of colchicine in a sustained drug delivery system. J Cataract Refract Surg.1993 July; 19 ( 4) 462-70.
- Pandey SK, Apple DJ, Werner L, Maloof AJ, Milverton EJ. Posterior Capsule Opacification: A Review of the Aetiopathogenesis, Experimental and Clinical Studies and Factors for Prevention .Indian J Ophthalmol 2004;52: 99-112.
- Sarbani Hazra, Himangshu Palui, Vemuganti Geeta. Comparison of design of intraocular lens versus the material for PCO prevention. Int J Ophthalmol.2012 Feb;5(1):59- 63.
- Chylack LT, Wolfe JK, Singer DM, et al. The Lens Opacities Classification System III. Arch Ophthalmol.1993;111(6):831–836.
- Sellman TR, Lindstrom RL.Effect of a planoconvex posterior chamber lens on capsular opacification from Elschnig pearl formation .J Cataract Refract Surg 1988;14:68-72
- Oner FH, Gunenc U, FerlielST.Posterior capsule opacification after phacoemuls-ification: Foldable acrylic versus poly (methylmethacrylate) intraocular lenses.J Cataract Refract Surg 2000; 26:722-6
- Nagata T, Watanbe I. Optic sharp edge or convexity: Comparison of effects on posterior capsule opacification .Jpn J Ophthalmol 1996;40:397-403.
- Goudinho SJ, Deeba F, Jacob JM. Incidence of posterior capsular opacification after small incision cataract surgery with PCIOL implantation using biconvex round edged PMMA IOL and square edged PMMA IOL. International Journal of Medical and Applied Sciences.2013;2:46- 59.
- Hollick EJ, Spalton DJ, Ursell PG, Meacock WR, Barman SA, Boyce JF. Posterior capsular opacification with hydrogel, polymethylmethacrylate and silicone intraocular lenses: Two-year results of a randomized prospective trial. Am J Ophthalmol 2000;129:577-84
- Long-term Posterior Capsule Opacification Reduction with Square-Edge Polymet-hylmethacrylate Intraocular Lens: Randomized Controlled StudyHaripriya A., Chang D.F., Vijayakumar B., Niraj A., Shekhar M., Tanpreet S., Aravind S.(2017) Ophthalmology, 124 (3) , pp. 295-302
- Nishi O,Nishi K ,WickstromK.Preventing lens epithelial cell migration using intrao-cular lenses with sharp rectangular edges. J Cataract Refract Surg 2000;26;1543-9
- Gagandeep SB, Grewal DS, Jagat R, Singla M, Pal S,Grewal S. Square edge polymethylmethacrylate intraocular lens design for reducing posterior capsule opacification following paediatric cataract surgery: initial experience. Clinical& Experimental Ophthalmology 2008;36(7):625-630
- Auffarth,GU ,GolesCU,A,Becker, KA et al .Quantification of posterior capsule opacification with round and sharped geintraocular lenses. Ophthalmoly. 2003;110:772-780
- Duman R et al. Effect of four different intraocular lenses on posterior capsule opacification. Int J Ophthalmol 2015;8(1):118-121.
- Ismail MM, Alio JL, Ruiz Moreno JM. Prevention of secondary cataract by antimitotic drugs: experimental study. Ophthalmic Res. 1996; 28(1):64 – 9.
- Malecaze F, Couderc B, de Neuville S, Serres B, Mallet J, Douin-Echinard V, Manenti S, Revah F, Darbon JM. Adenovirus-mediated suicide gene transduction: feasibility in lens epithelium and in prevention of posterior capsule opacification in rabbits. Hum Gene Ther. 1999;10:2365–72.
Corresponding Author
Dr Bandopadhyay Shweta
Assistant Professor, Dept of Ophthalmology, Dr Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon, Nashik
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.41
