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.
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.
['Menapace|Rupert|R|https://orcid.org/0000-0002-2560-7082', 'Schriefl|Sabine|S|', 'Lwowski|Christoph|C|', 'Leydolt|Christina|C|https://orcid.org/0000-0001-7646-8804']
D000180:Acrylic Resins D000368:Aged D019923:Capsulorhexis D005260:Female D005500:Follow-Up Studies D006801:Humans D053685:Laser Therapy D053844:Lasers, Solid-State D019654:Lens Implantation, Intraocular D007910:Lenses, Intraocular D008297:Male D019060:Minimally Invasive Surgical Procedures D057852:Posterior Capsule of the Lens D011446:Prospective Studies D011474:Prosthesis Design D012826:Silicone Elastomers D013997:Time Factors
primary posterior capsulorhexis posterior capsule opacification YAG laser capsulotomy ZEISS CT Asphina 409MV plate-haptic acrylic micro-incision intraocular lens