Anterior and posterior capsular opacification with the Tecnis ZCBOO and AcrySof SA60AT IOL
Reviewed by Jonathan Chan

This a randomised, controlled, prospective and double-blind study comparing the anterior capsular opacification (ACO) and posterior capsular opacification (PCO) outcomes with two types of single-piece hydrophobic acrylic intraocular lenses (IOL), and AcrySof SA60AT – Group A, and Tecnis ZCBOO – Group B. A total of 148 eyes of 74 patients were recruited in the study between the age of 61-80 years of age with bilateral senile cataracts. Patients were recruited between the period of October 2009 and September 2010 at the Hospital of St. John of God (Vienna). Each patient underwent cataract surgery with implantation of an AcrySof SA60AT Group A in one eye and Tecnis ZCB00 Group B in the fellow eye by the same experienced surgeon. The lens allocation to the first or second operated eye followed a randomised process. All patients were followed up for a total of 12-months postoperatively and the PCO level was evaluated with the evaluation of posterior capsular opacification software, whereas the level of ACO and capsular retraction was evaluated and graded subjectively by the surgeons in the study. The mean PCO score was 0.1±0.17 and 0.21±0.89 in Group A and B respectively, with no statistically significant differences between the groups (p=0.47). No significant correlation was found between the PCO scores in Groups A and B (p=0.17). Regarding ACO, it was found in 15 eyes (20.3%) and two eyes (2.7%) in Groups A and B respectively (p=0.37). Anterior capsular phimosis was found in 13 eyes (17.6%) in the AcrySof SA60AT group. The incidence of glistenings was also found to only be in Group A implanted with AcrySof IOLs; the phenomenon was observed in 66.2%. The authors concluded that there were similar low rates of PCO one year after cataract surgery. It appears to be a difference in the anterior capsular opacification behaviour between the IOL models; the AcrySof SA60AT has a high incidence of ACON capsular phimosis as above. The authors suggest that the high incidence of the ACO could be related to the design of the square edge optic with exclusion of the optic-haptic junction in the Acrysof SA60AT IOL, whereas with the Tecnis IOL the square edge is continuous (360°). The high incidence of capsular phimosis suggests this could be related to the configuration of the surfaces of the IOL that may play a role in the trend to have a more significant capsular phimosis in the Acrysof group. The authors suggest this could also be related to the haptic angulation, whereas in the Tecnis group there is a biconvex IOL with aspheric anterior surface and haptic offset for three points of fixation. In the Acrysof group it is a biconvex lens with haptic angulation of 0.

Anterior and posterior capsular opacification with the Tecnis ZCBOO and AcrySof SA60AT IOL: a randomised intraindividual comparison (CR).
Kahraman G, Schrittwieser H, Walch M, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2014;98:905-9.