Weinand F. S., Lazar M., Becker R.

Zentrum für Augenheilkunde der Universität Gießen, Friedrichstr. 18, D- 35385 Gießen

Objective: The developement of posterior capsule opacification (PCO) after extracapsular cataract extraction is the most frequent long-term complication. Time between implantation of silicone and poly(methyl metacrylate) (PMMA) intraocular lenses (IOL) and Nd:YAG laser capsulotomy (YAG-LC) due to vision reduction has already been discribed. The aim of this investigation was to compare this two IOL-materials with a hydrogel-IOL in normal eyes and eyes with diabetic retinopathy.
Methods: In a retrospective study all patients which were sent to our clinic for YAG-LC from January 1995 to December 1999 were included. Time interval between IOL-implantation and laser of PCO (Zeiss Visulas laser) as well as the IOL material were documented. Our study comprised 567 eyes without additional ocular pathology and 48 eyes with diabetic retinopathy. Each group were divided in three subgroups for hydrogel-, silicone- and PMMA-IOL.
Results: (1) Normal eyes: vision impairing PCO developed in mean in the hydrogel group after 15.42 months (n=62, mean: age = 74, vision before YAG-LC = 0.48), after 18.01 months in the silicone group (n=178, mean: age = 67, vision = 0.48) and after 44.01 months in the PMMA group (n=327, mean: age = 72, vision = 0.45). (2) Diabetic eyes: mean of hydrogel group 8.04 months (n=14, mean: age = 74, vision =0.27), silicone group 20.7 months (n=16,mean: age = 71, vision = 0.45) and PMMA group 24.91 months (n=18, mean: age = 71, vision = 0.2). Difference between groups were statistically significant (p<0.05).
Conclusion: In normal eyes vision impairing PCO developed earlier after implantation of hydrogel or silicone IOL, whereas it took longer to develop in PMMA IOL. In diabetic eyes PCO developed faster in hydrogel-IOL and PMMA -IOL.

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