Comparison Study On Anterior Capsule Contraction And Centration Of Different Hydrophilic And Hydrophobic Intraocular Lenses After Operation

Purpose:To compare the anterior capsule contraction and centration of intraocular lenses between hydrophilic acrylic intraocular lenses(IOL)MI60 and 509M and hydrophobic acrylic IOL(i Sert250 and ZCB00)after femtosecond laser-assisted cataract surgery.Method:This prospective consecutive nonrandomized comparative cohort study was conducted from August 2016 to December 2017 in Eye Center,Second Affiliated Hospital of School of Medicine,Zhejiang University,Hangzhou,China.The patients who underwent femtosecond laser-assisted cataract surgery by the same experienced surgeon were scheduled to implant MI60,509M,i Sert250 or ZCB00.Uncorrected and corrected distance visual acuity,anterior segment photography of slit lamp microscope,optical coherence tomography and itrace vision function analyzer were evaluated and performed postoperatively at 1 week,1 month,3 months,and 1 year.Auto CAD2014 software was used to calculate the area and perimeter of anterior capsule contraction.All analyses were performed using SPSS 22.0.Results:A total of 320 patients(320 eyes)were included.No adverse events occurred during the surgeries and no postoperative complications were observed.(1)The reduction of the anterior capsular area(mm~2)and circumference(mm)in hydrophilic group postoperatively at 1 month,3 months and 1 year was greater than that in hydrophobic group(1.27±1.55 vs 0.61±0.59,p<0.001;2.62±2.19 vs1.44±0.94,p<0.001;3.21±2.20 vs 1.86±1.05,p<0.001),(0.54±0.65 vs 0.30±0.25,p<0.001;1.09±0.98 vs 0.64±0.39,p<0.001;1.40±1.04 vs 0.84±0.45,p<0.001).(2)MI60 group had the largest reduction of anterior capsular area and circumference postoperatively at all points in time.i Sert250 group and ZCB00 group had the least reduction of anterior capsular area and circumference,and there is no significant difference between two hydrophobic group.The reduction of anterior capsular area of 509M group were smaller than MI60 group(1.07±1.30 vs 1.50±1.78,p=0.018;2.01±1.43 vs 3.35±2.67,p<0.001;2.51±1.50 vs 4.04±2.59,p<0.001),and larger than i Sert250 group and ZCB00 group(p<0.05).(3)The anterior capsular contraction is time-dependent.In 3 months after surgery,the contraction speed is faster,the area shrinks and the circumference shortens more than that after postoperatively 3 months.After that,the contraction speed gradually decreases.From postoperatively 1 month to 3 months,all groups had the largest reduction of anterior capsular area and circumference.From postoperatively 3 months to 1 year,all groups had the least reduction of anterior capsular area and circumference.(4)1 year after surgery,the incidence of uncomplete capsule overlap of MI60and 509M group was higher than that of i Sert250 and ZCB00 group(10.7%vs 10.1%vs 2.4%vs 2.8%,p=0.047).The anterior capsule had the best overlap for ZCB00group.The capsule overlap of MI60 group and i Sert250 group was not as good as the other two groups.(5)1 year after operation,there were no significant statistical differences between the horizontal eccentric distance,vertical eccentric distance,and total eccentric distance of 4 groups(p=0.096;p=0.199;p=0.301).There was no significant difference in the corrected visual acuity of 4 groups(p=0.488).There were no significant differences in the incidence of patients with laser treatment of capsular contraction syndrome(MI60 2.7%vs 509M 1.1%vs i Sert250 0 vs ZCB00 0,p=0.270).The incidence of PCO laser treatment of MI60 group and 509M group was higher than that of i Sert250 group and ZCB00 group(8.0%vs 12.4%vs 2.4%vs2.8%,p<0.001).Conclusion:In conclusion,after femtosecond laser-assisted cataract surgery,the capsules of the hydrophobic acrylic lens were more biocompatible than that of the hydrophilic acrylic lens.The hydrophilic acrylic IOL MI60 and 509M group had greater postoperative capsular contraction than the hydrophobic acrylic IOL i Sert250 and ZCB00 group.MI60 group had postoperative capsular contraction greater than 509M group.The surface hydrophobic modification can reduce the anterior capsular contraction.There was no difference between i Sert250 and ZCB00 group.The anterior capsular contraction is time-dependent.The hydrophilic group had higher incidence of uncomplete overlap and PCO laser treatment than that of hydrophobic group.The hydrophilicity and hydrophobicity of the intraocular lens material has little effect on its decentration.