posterior capsular opacification: hydrophilic acrylic versus pmma intraocular lenses

purpose: to compare the effect of implantation of a single-piece hydrophilic foldable acrylic intraocular lens (iol) with rectangular optic edge and a single-piece polymethyl methacrylate (pmma) iol with rounded optic edges on posterior capsular opacification )pco(. methods: this randomized clinical trial study comprised 74 eyes with senile cataract in an otherwise normal eye in patients older than 50 years. patients were randomized to receive hydrophilic foldable acrylic or pmma iols. the operations were performed using standard phacoemulsification by the same surgeon. patients were followed for at least 9 months. pco was graded according to slit lamp examination (retroillumination) and best corrected visual acuity (bcva). the pco values and bcva at 6 and 9 months after surgery, capsulorrhexis diameter, and post operative inflammation were compared between the two groups. results: from 74 patients enrolled in the study, 56 patients including 28 in each group, had complete follow up and examinations. mean age was 67.64±7.71 years. six months after surgery visually significant pco occurred in 2 patients (7.1%) in the acrylic group and 7 patients (25%) in the pmma group. (p=0.001) at 9 months yag capsulotomy was performed in one eye (3.6%) in the acrylic group and 3 eyes (10.7%) in the pmma group. (p=0.61) there was no correlation between pco with age (p=0.13) or capsulorrhexis diameter (p= 0.8). conclusion: hydrophilic acrylic iols cause less pco than pmma iols. however, the results can not attributed to the iol material alone as they show the importance of both material and design.