Effect of four different intraocular

lenses on posterior
capsule opacification

Rasyidafdola Gistadevhadi
Kepaniteraan Klinik Ilmu Kesehatan Mata
RST Kota Semarang
Periode 30 Mei-25 Juni 2016
 Introduction
Cataract Surgery

Posterior Capsule
Material of IOLs Surgery Method
Opasification

Laser Nd:YAG
 Subject and Methods
• Study Population
– Data was collected retrospectively for 4970 consecutive eyes of
4013 patients
• Inclusion
– patients with senile cataract who underwent uncomplicated
phacoemulsification surgery and IOL implantation performed by
one surgeon (Karel F) at the Ankara University Faculty of
Medicine, Department of Ophthalmology between January
2000 and January 2008.
• Exclusion
– concomitant ocular pathologies (uveitis or history of uveitis high
myopia (>S-6D )
– previous trauma or had suffered any intra operative
complication (capsulorhexis rim tear, zonular rupture, posterior
capsule rupture with or without vitreous loss or the usage of the
capsule tension ring)
Devided into 4 groups based on 4 different IOLs

• Group 1 :AcrySof SN60AT (Alcon Laboratories, Inc., Fort

Worth, TX, USA), 1-piece acrylic hydrophobic IOL with a
6.0 mm optic diameter, a 13.0 mm overall diameter
and acrylic haptics angled at 0°, was implanted in 1399
eyes of 1014 patients.
• Group 2 : AcrySof MA30BA (Alcon Laboratories, Inc.,
Fort Worth, TX, USA), a 3-piece acrylic hydrophobic IOL
with a 5.5 mm optic diameter, a 12.5 mm overall
diameter and poly methyl metahacrylate (PMMA)
haptics angled at 5°, was implanted in 1509 eyes of
1242 patients.
• Group 3 : AcrySof MA60BM (Alcon Laboratories,
Inc., Fort Worth, TX, USA), a 3-piece acrylic
hydrophobic IOL with a 6.0 mm optic diameter, a
13.0 mm overall diameter and PMMA haptics
angled at 10°, was implanted in 1501 eyes of
1324 patients.
• Group 4 : Aqua-SenseTM III (Aaren Scientific
Inc.,Ontario, USA) a 3-piece acrylic hydrophilic
IOL with a 6.0 mm optic diameter, a 12.5 mm
overall diameter and acrylic haptics angled at 5°,
was implanted in 561 eyes of 433patients.
 Surgeon
• (Karel F)
• Ankara University Faculty of Medicine,
Department of Ophthalmology between
January 2000 and January 2008
 Post operative treatment

• Dexamethason topical 0,1%

• Ciprofloxasin topical
• 5 time daily for 1mo
 Statistical analysis
Major outcome • PCO development associated with each IOL

The differences between

• Were compared using a Z test
groups

statistical significance of • assessed using the Chi-squaretest. A valuePless

differences in frequencies than 0.05 was considered statisticallysignificant.

Analysis • SPSS 13.0software SPSS Inc., Chicago, USA)

 RESULT
Mean of PCO requiring Mean time PCO
Sign. Sig.
age Nd:YAG laser/% developement
Group 1 67.90±9.55 41 eyes/2.93% 0,74 13.21±10.02mo 0,001
66.90±10.7
Group 2 41 eyes/2.72% 0,71 33.11±25.06mo
3
Group 3 69.33±8.44 45 eyes/3.00% 0,71 22.25±16.02mo

Group 4 70.03±9.56 26 eyes4.63% 0,015 39.91±15.52mo 0,001

 DISCUSSION
• The incidence of PCO is affected by many factors.
• Thedevelopment of modern foldable IOLs with square-edgedoptics has greatly
reduced the incidence of PCO followingcataract surgery.

• The sharp optic edge, now known to be a major inhibitoryfactor for PCO
recent development
studies

• The clinical introduction of 1-piece acrylic hydrophobic IOLswith some differences in

optic andhapticdesign wasexpected to be associated with a different rate of
PCOdevelopment compared with 3-piece acrylic hydrophobicIOLs.
Camparasion • 1y after surgery, 1-piece acrylic IOLs areassociated with slightly
of IOLs moreregeneratoryPCO than 3-pieceacrylic IOLs made from the same material.
material • the modification of an IOL from a3-piece to a 1-piecehapticdesign caused no
significantchange in the development of PCO.
 • hydrophilic acrylic lenses provide a suitable
environment for lens epithelial cellsmigration
IOLs because of the hydrophilic surface properties.
causing
PCO • Previous studies have reported that
hydrophobic IOLs areassociated with lower
rates of PCO than hydrophilicIOLs

The • According to our results, eyes with

needed acrylichydrophobicoptic IOLs were more likely
of
Nd:YAG to requireNd:YAGlasercapsulotomythan eyes
laser with acrylichydropholicopticIOLs.
 Conclusion

• A higher percentage ofeyes with

hydrophilic acrylic IOLs developed
PCO than eyeswith acrylic
hydrophobic IOLs.
• no significantdifference in the long-
summary term PCO rate of a1- or 3-
piecehapticlens design.
• Eyes with acrylic hydrophilic IOLs did
notrequire
anNd:YAGlasercapsulotomyas soon
as eyes withacrylic hydrophobic IOLs.
 CRITICAL
APPRAISAL
 Judul dan Pengarang
No Kriteria Ya (+) atau Tidak (-)
1. Jumlah kata dalam judul < +
12 kata
2. Deskripsi judul Menggambarkan isi utama penelitian,
cukup menarik, tanpa singkatan, tidak
digarisbawahi, tidak diakhiri tanda
titik, tidak ditulis di antara tanda kutip.

3. Daftar penulis sesuai +

aturan jurnal
4. Korespondensi penulis +
5. Tempat dan waktu +
penelitian dalam judul
6. Subyek penelitian +
 Abstrak
No Kriteria Ya (+) atau Tidak (-)

1. Abstrak 1 paragraf +

2. Mencakup AMRC +

3. Secara keseluruhan informatif +

4. Tanpa singkatan selain yang baku +

5. Kurang dari 250 kata + (216 kata)

6. Tidak menuliskan kutipan pustaka +

 Pendahuluan
No. Kriteria Ya (+) atau Tidak (-)

1. Terdiri dari 2 bagian atau paragraf - ( 3 paragraf)

2. Alasan dilakukan penelitian +

3. Penelitian sebelumnya -

4. Tujuan penelitian, hipotesis penelitian +

5. Didukung pustaka yang relevan +

6. Kurang dari 1 halaman +

 Metode
No. Kriteria Ya (+) atau Tidak (-)
1. Jenis & rancangan penelitian +
2. Waktu dan tempat penelitian +
3. Populasi sumber dan jumlah sampel +
4. Teknik sampling -
5. Kriteria inklusi +
6. Kriteria eksklusi +
7. Perincian cara penelitian -
8. Uji statistik (p < 0,05) +
9. Program komputer +
10. Persetujuan subyektif -
 Hasil
No. Kriteria Ya (+) atau Tidak (-)

1. Jumlah subyek +

2. Tabel karakteristik subyek -

3. Tabel hasil penelitian +

4. Komentar dan pendapat penulis tentang -

hasil
 Pembahasan, Kesimpulan, Daftar
Pustaka
No. Kriteria Ya (+) atau Tidak (-)
1. Pembahasan dan kesimpulan terpisah -
2. Pembahasan dan kesimpulan dipaparkan +
dengan jelas
3. Pembahasan mengacu dari penelitian +
sebelumnya
4. Pembahasan sesuai landasan teori +
5. Keterbatasan penelitian -
6. Simpulan utama +
7. Simpulan berdasarkan penelitian +

8. Saran penelitian -
9. Penulisan daftar pustaka sesuai +
 Apakah hasil penelitian
Apakahpenelitianinipenti tersebut mungkin untuk
ng? diterapkan pada pasien
kita ?
Penting bagi
Tidak bisa,
praktisi kesehatan
mengingat
mata untuk
sebagian besar
mengetahui
pasien kita BPJS
perkembangan
sehingga opsi
tentang pengaruh
untuk jenis lensa
jenis IOLs
yang spesifik
terhadap insidensi
terbatas
PCO