A long-term follow-up study of different irrigation/aspiration techniques on formation of posterior capsule opacification

Abstract

Background: This study was designed to determine the effect of 2 different irrigation/aspiration techniques on the formation of posterior capsule opacification (PCO) after cataract surgery in which CeeON Edge 911A (Pharmacia, Sweden) sharp-edged silicone lenses were implanted.

Methods: In this prospective study, 60 eyes from 39 patients, average age 65 (range: 46-85) years, were analyzed. Lens extraction was performed by phacoemulsification, and CeeON Edge 911A intraocular lenses were implanted. Two different irrigation/aspiration techniques were used in which the cortex of 32 eyes was removed by coaxial irrigation/aspiration (this group was designated group I) and the cortex of 28 eyes was removed by bimanual irrigation/aspiration (this group was designated group II). Secondary cataract formation and visual acuity were evaluated and compared in both groups.

Results: The average follow-up time was 44 (SD 11) months. In group I, secondary cataract formation causing 2 lines of decrease on visual acuity was observed in 1 eye 8 months after the operation. The secondary cataract developed in the form of cortex migration. This patient was treated with laser (Neodymium: Yttrium Aluminum Garnet [Carl Zeiss Meditech, Germany]) capsulotomy at the time of detection. Best corrected visual acuity for all eyes was 0.5 and higher; postoperative refractive error ranged between +1.0 and -2.0 diopters.

Interpretation: Although CeeON Edge 911A silicone lenses with sharp edge prevent formation of PCO very effectively, in 1 eye in the coaxial irrigation/aspiration group, 2 lines of decrease on visual acuity were observed due to PCO. However, we did not find any significant difference between the 2 irrigation/aspiration techniques with respect to PCO formation. In terms of complete removal of the cortical material, the bimanual irrigation/aspiration technique was found to be superior to the coaxial irrigation/aspiration technique because of the better accessibility to all areas of the capsular bag.