Group 1, 2, and 3 were implanted with 1-piece and 3-piece acrylic hydrophobic IOLs, while Group 4 was implanted with a hydrophilic acrylic IOL. A higher percentage of eyes with hydrophilic IOLs developed PCO compared to hydrophobic IOLs. There was no significant difference in PCO rates between 1-piece and 3-piece hydrophobic IOLs. Eyes with hydrophilic IOLs required Nd:YAG laser treatment later than eyes with hydrophobic IOLs. The study concludes that hydrophilic IOLs are associated with a higher risk of PCO development compared to hydrophobic IOLs.

1. Effect of four different intraocular
lenses on posterior
capsule opacification
Naim Ismail Imunu
Kepaniteraan Klinik Ilmu Kesehatan Mata
RSUD R. Soedjati Purwodadi

2. Introduction
Cataract Surgery
Posterior Capsule
Opasification
Surgery Method
Laser Nd:YAG
Material of IOLs

3. 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)

4. 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.

5. • 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.

6. Surgeon
• (Karel F)
• Ankara University Faculty of Medicine,
Department of Ophthalmology between
January 2000 and January 2008

7. Post operative treatment
• Dexamethason topical 0,1%
• Ciprofloxasin topical
• 5 time daily for 1mo

8. Statistical analysis
• PCO development associated with each IOLMajor outcome
• Were compared using a Z testThe differences between
groups
• assessed using the Chi-square test. A value P
less than 0.05 was considered
statisticallysignificant.
statistical significance of
differences in frequencies
• SPSS 13.0 software SPSS Inc., Chicago, USA)Analysis

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

11. DISCUSSION
• The incidence of PCO is affected by many factors.
• The development of modern foldable IOLs with square-edged optics has greatly
reduced the incidence of PCO following cataract surgery.
recent
studies
• The sharp optic edge, now known to be a major inhibitory factor for PCO
development
Camparasion
of IOLs
material
• The clinical introduction of 1-piece acrylic hydrophobic IOLs with some differences in
optic and haptic design was expected to be associated with a different rate of PCO
development compared with 3-piece acrylic hydrophobic IOLs.
• 1y after surgery, 1-piece acrylic IOLs are associated with slightly more regeneratory
PCO than 3-piece acrylic IOLs made from the same material.
• the modification of an IOL from a 3-piece to a 1-piece haptic design caused no
significant change in the development of PCO.

12. • hydrophilic acrylic lenses provide a suitable
environment for lens epithelial cells migration
because of the hydrophilic surface properties.
• Previous studies have reported that
hydrophobic IOLs are associated with lower
rates of PCO than hydrophilic IOLs
IOLs
causing
PCO
• According to our results, eyes with acrylic
hydrophobic optic IOLs were more likely to
require Nd:YAG laser capsulotomy than eyes
with acrylic hydropholic optic IOLs.
The
needed
of
Nd:YAG
laser

13. Conclusion
• A higher percentage of eyes with
hydrophilic acrylic IOLs developed
PCO than eyes with acrylic
hydrophobic IOLs.
• no significant difference in the long-
term PCO rate of a1- or 3-piece
hapticlens design.
• Eyes with acrylic hydrophilic IOLs did
not require an Nd:YAG laser
capsulotomy as soon as eyes with
acrylic hydrophobic IOLs.
summary

14. CRITICAL
APPRAISAL

15. 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 +

16. 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 +

17. 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 +

18. 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 -

19. Hasil
No. Kriteria Ya (+) atau Tidak (-)
1. Jumlah subyek +
2. Tabel karakteristik subyek -
3. Tabel hasil penelitian +
4. Komentar dan pendapat penulis
tentang hasil
-

20. 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 +

21. Apakah penelitian ini
penting ?
Penting bagi
praktisi kesehatan
mata untuk
mengetahui
perkembangan
tentang pengaruh
jenis IOLs
terhadap insidensi
PCO
Apakah hasil penelitian
tersebut mungkin untuk
diterapkan pada pasien
kita ?
Tidak bisa,
mengingat
sebagian besar
pasien kita BPJS
sehingga opsi
untuk jenis lensa
yang spesifik
terbatas