Relationship of AcrySof acrylic and PhacoFlex silicone intraocular lenses to visual acuity and posterior capsule opacification

Purpose: To compare the changes in visual acuity and the development of posterior capsule opacification (PCO) with AcrySof® acrylic intraocular lenses (IOLs) (Alcon Laboratories) and second-generation PhacoFlex® silicone IOLs (Allergan). Setting: Eye Associates of New Mexico and Southwest Colorado, Albuquerque, New Mexico, USA. Methods: Medical charts of patients having cataract extraction with implantation of an AcrySof MA30BA or MA60BM (MA30/60) or PhacoFlex SI-30NB or SI-40NB (S1-30/40) IOL between January 1995 and June 1997 were abstracted. Analyzed were the changes in visual acuity and development of PCO 1 month postoperatively and at the last available ophthalmologist visit or the visit before neodymium: YAG (Nd:YAG) capsulotomy. Results: Patients with MA30/60 acrylic IOLs were significantly older, had a worse preoperative best corrected visual acuity (BCVA), and had more concomitant ocular diseases than those with S1-30/40 silicone IOLs. The change in BCVA from preoperatively to 1 month postoperatively was equivalent in the 2 tens groups. The BCVA declined from 1 month postoperatively to the last recorded or pre-Nd: YAG visit. This decline was greater in eyes with S1-30/40 silicone IOLs than in those with MA30/60 acrylic IOLs. Although the decrease in BCVA between IOL types was not significantly different, eyes with a S1-30/40 silicone IOL were significantly more likely to develop PCO and have Nd:YAG capsulotomy. Eyes developing PCO had a statistically significant decline in BCVA from 1 month postoperatively to the last/pre-Nd:YAG visit. Conclusions: The MA30/60 acrylic lenses were associated with lower PCO and Nd:YAG capsulotomy rates than second-generation S1-30/40 silicone IOLs. Patients with MA30/60 IOLs also tended to have less of a decrease in visual acuity than patients with S1-30/40 silicone lenses, probably as a result of the difference in PCO rates between groups.