Comparison of the stability of 1-piece and 3-piece acrylic intraocular lenses in the lens capsule

Abstract

Purpose: To compare the degrees of intraocular lens (IOL) decentration, tilt, and longitudinal movement; the refractive change; and anterior capsule contraction after cataract surgery between eyes with a 1-piece acrylic IOL with soft acrylic loops and eyes with a 3-piece acrylic IOL with rigid poly(methyl methacrylate) loops.

Setting: Hayashi Eye Hospital, Fukuoka, Japan.

Methods: Fifty-six patients had implantation of a 1-piece acrylic IOL in 1 eye and a 3-piece acrylic IOL in the fellow eye. The degree of IOL decentration and tilt, the anterior chamber depth (ACD), and the area of anterior capsule opening were measured using Scheimpflug videophotography 3 days and 1, 3, and 6 months postoperatively. The postoperative refractive status was also examined.

Results: The mean degrees of decentration and tilt in the 1-piece IOL group were similar to those in the 3-piece IOL group throughout the follow-up. The ACD did not change after surgery in the 1-piece group but showed significant shallowing in the 3-piece group (P < .0001). The spherical equivalent (SE) did not change in the 1-piece group, while the SE had a significant myopic shift of approximately 0.4 diopter in the 3-piece group. The percentage of anterior capsule contraction was similar between the groups.

Conclusions: The degree of IOL decentration and tilt and percentage of anterior capsule contraction in eyes with a 1-piece acrylic IOL with soft acrylic loops were similar to those in eyes with a 3-piece acrylic IOL. The longitudinal movement of the 1-piece IOL was less than the movement of the 3-piece IOL, resulting in less postoperative myopic shift.