The effect of capulorhexi ize on poterior capular opacification: one-year reult of a randomized propective trial Original Reearch Article

PURPOE: Poterior capular opacification i the mot common urgically related caue of reduced viion after cataract urgery. We tudied the effect of capulorhexi ize on the pattern and everity of poterior capular opacification. METHOD: In thi propective tudy 75 patient underwent tandardized phacoemulification with capulorhexi and in-the-bag placement of a 5.5-mm polymethylmethacrylate intraocular len implant. The patient were randomly aigned to receive either a mall capulorhexi of 4.5 to 5 mm to lie completely on the intraocular len optic or a large capulorhexi of 6 to 7 mm to lie completely off the len optic. Patient were examined at day 1, 14, 30, 90, and 180 and at year 1 with logMAR viual acuity aement, Pelli-Robon contrat enitivity teting, anterior chamber flare and cell meaurement, and high-reolution digital retroillumination imaging of the poterior capule. The pattern of poterior capular opacification wa determined, and the percentage area of poterior capular opacification wa calculated for each image with dedicated image analyi oftware. REULT: Large capulorhexe were aociated with ignificantly more wrinkling of the poterior capule and wore poterior capular opacification than mall capulorhexe. At 1 year the average percentage area of poterior capular opacification wa 32.7% for mall capulorhexe (95% confidence interval, 19.8 to 45.6) and 66.2% for large capulorhexe (95% confidence interval, 57.7 to 74.6) (P = .0001). The patient with large capulorhexe had ignificantly poorer viual acuitie and a trend toward wore contrat enitivitie. CONCLUION: Thi tudy demontrated ignificantly greater wrinkling and opacification of the poterior capule and wore viual acuity with large capulorhexe than with mall capulorhexe. In cataract urgery with a polymethylmethacrylate intraocular len, a mall capulorhexi with the edge completely on the urface of the implant i preferable to a large capulorhexi in reducing poterior capular opacification.