Intraocular Lens Design Influence in Nd:YAG Laser Rates for Large Series of MICS IOL Implantations
Purpose
To study the cumulative neodymium: YAG (Nd:YAG) laser rate after 4636 implantations during cataract surgery of 5 different hydrophilic acrylic MICS lens and evaluate influence of material and design.
Methods
This retrospective study comprises all patients who were implanted between 2006 and the end of 2013 with one of the after 5 micro-incision IOLs: Akreos MICS and INCISE (Bausch and Lomb), CT Asphina (Zeiss), MicroSlim and Micro AY (PhysIOL). The postoperative follow-up ranges from 1 to 84 months. The cumulative Nd:Yag laser frequency rates in all groups were calculated, and the cumulative incidence rates were defined by Kaplan-Meier survival analysis and Mann-Withney test with a significance threshold of 0.05.
Results
The 3-year survival percentage was 39% for the Akreos MICS (95% CI :32-48) ; 100% for the INCISE (no yag so far) ; 67.50% for the CT Asphina (95% CI :61-75) ; 79.10% for the MicroSlim (95% CI :75-83) ; 67.60% for the Micro AY (95% CI:64-71) ; the 5-year survival percentage was 16.70% for the Akreos MICS (95% CI :10-28) ; 24.50% for the CT Asphina (95% CI :14-43) ; 61.50% for the MicroSlim (95% CI :55-68) ; 53.50% for the Micro AY (95% CI:49-59).
Conclusion
There is no excessive PCO after MICS lens implantation. The cumulative Nd:Yag laser rates after micro-incision implantation were comparable for Micro AY and MicroSlim. The Akreos MICS lens shows the highest Nd:YAG rate. The CT Asphina shows a low Nd:YAG rate at 3 years but increases dramatically after. The INCISE with is sharper barrier edge could give a lower PCO rate in the future.