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Review
. 2022 Feb 25:2022:3570399.
doi: 10.1155/2022/3570399. eCollection 2022.

Posterior Capsule Opacification after Cataract Surgery via Implantation with Hydrophobic Acrylic Lens Compared with Silicone Intraocular Lens: A Systematic Review and Meta-Analysis

Ye Rin Kwon  1 , Yoo Na Hwang  2 , Sung Min Kim  1   2
Affiliations
Review

Posterior Capsule Opacification after Cataract Surgery via Implantation with Hydrophobic Acrylic Lens Compared with Silicone Intraocular Lens: A Systematic Review and Meta-Analysis

Ye Rin Kwon et al. J Ophthalmol. .

Abstract

Hydrophobic acrylic intraocular lens (IOL) is the most popular material in cataract surgery. Posterior capsule opacification (PCO) is a long-term complication of cataract surgery. It can impair vision and adversely affect the prognosis of IOL delamination. The objective of this study was to perform a systematic review and meta-analysis to provide an updated evaluation of long-term complications and visual function after implantation with hydrophobic acrylic and silicone intraocular lenses. PubMed, Embase, and Cochrane Library were searched from January 2000 until March 2021. Randomized controlled trials (RCTs) and retrospective studies were finally included. The main outcomes were PCO value and neodymium-doped yttrium aluminum garnet (Nd : YAG) capsulotomy rate. Subgroup analysis was performed to compare hydrophobic acrylic and silicone IOLs during the follow-up period. Sensitivity analysis was also performed. The meta-analysis included a total of 17 studies. When the follow-up period was considered, the results of the analysis revealed higher PCO value (Group 3: standardized mean difference (SMD), -0.59; 95% confidence interval (CI), -0.90 to -0.28) and Nd : YAG capsulotomy rate (Group 3: risk ratio (RR), 0.60; 95% CI, 0.40-0.89) for hydrophobic acrylic IOLs than silicone IOLs during a long-term (≥6 years) follow-up. In conclusion, both the PCO value and the Nd : YAG capsulotomy rates were higher in hydrophobic acrylic IOLs group than the silicone IOLs group at long-term use (more than 6 years) after implantation.

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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
PRISMA flow diagram outlining study selection.
Figure 2
Figure 2
Risk of bias assessment of RCTs.
Figure 3
Figure 3
Risk of bias assessment of non-RCTs.
Figure 4
Figure 4
Comparison of subgroup effects on PCO value between hydrophobic acrylic and silicone IOLs. In the long-term group (G3, follow-up period ≥6 years), hydrophobic acrylic IOLs showed significantly high PCO values than silicone IOLs. Chi2 = chi-square statistic; CI = confidence interval; df = degrees of freedom; I2 = I-squared, heterogeneity statistic; IOL = intraocular lens; IV = inverse variance; PCO = posterior capsule opacification; SMD = standard mean difference; Z = Z-statistic.
Figure 5
Figure 5
Comparison of subgroup effects on Nd : YAG capsulotomy rates between hydrophobic acrylic and silicone IOLs. In the long-term group (G3, follow-up period ≥6 years), hydrophobic acrylic IOLs were associated with significantly higher Nd : YAG capsulotomy rates than silicone IOLs. Chi2 = chi-square statistic; CI = confidence interval; df = degrees of freedom; I2 = I-squared, heterogeneity statistic; IOL = intraocular lens; M-H = Mantel-Haenszel estimate; RR = risk ratio; Z = Z-statistic.
Figure 6
Figure 6
Comparison of ACO values between hydrophobic acrylic and silicone IOLs, showing no statistically significant differences between the two IOLs. Chi2 = chi-square statistic; CI = confidence interval; df = degrees of freedom, I2 = I-squared, heterogeneity statistic; IOL = intraocular lens; IV = inverse variance; SMD = standard mean difference; Z = Z-statistic.
Figure 7
Figure 7
Comparison of visual acuity (BCVA) between hydrophobic acrylic and silicone IOLs, showing no statistically significant differences between the two IOLs. BCVA = best-corrected visual acuity; Chi2 = chi-square statistic; CI = confidence interval; df = degrees of freedom; I2 = I-squared, heterogeneity statistic; IOL = intraocular lens; IV = inverse variance; MD = mean difference; Z = Z-statistic.
Figure 8
Figure 8
Comparison of tilt between hydrophobic acrylic and silicone IOLs, showing no statistically significant differences between the two IOLs. Chi2 = chi-square statistic; CI = confidence interval; df = degrees of freedom; I2 = I-squared, heterogeneity statistic; IOL = intraocular lens; IV = inverse variance; MD = mean difference; Z = Z-statistic.
Figure 9
Figure 9
Comparison of decentration between hydrophobic acrylic and silicone IOLs, showing no statistically significant differences between the two IOLs. Chi2 = chi-square statistic; CI = confidence interval; df = degrees of freedom; I2 = I-squared, heterogeneity statistic; IOL = intraocular lens; IV = inverse variance; MD = mean difference; Z = Z-statistic.
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