A systematic review has found the choice of the intraocular lens (IOL) edge design and the material seem to have a “significant influence” on the development of posterior capsule opacification (PCO) – a common complication after cataract surgery.
The review found that IOLs with sharp optic edges should be preferred, and silicone IOLs seem to be a better choice.
Study authors searched 5,957 unique records from seven publication databases, ultimately including 59 randomised control trials or cohort studies in their review.
The purpose of the study was to compare the effects of different IOLs on PCO development after cataract surgery. They compared IOL materials, IOL edge designs, one-piece versus three-piece IOLs, and spherical versus aspheric IOLs.
The meta-analysis found that, when excluding the effects of optic edges and other differences, the rate of PCO for hydrophobic acrylic IOLs was significantly lower than that for hydrophilic acrylic IOLs. In addition, the PCO rate for silicone IOLs was significantly lower than that for hydrophobic acrylic and polymethyl methacrylate (PMMA) IOLs.
In assessing the edge design on PCO, the meta-analysis showed significantly lower PCO rates in IOLs with sharp posterior optic edges than in IOLs with round optic edges.
There was no statistically significant difference between one-piece and three-piece IOLs on PCO rates, and no difference between spherical and aspherical IOLs in relation to PCO.
Reference
- Luo H, Zhang G, Qu C, et al. The influence of different types of intraocular lenses on the development of posterior capsular opacification: a systematic review. BMC Ophthalmol. Published online 22 September 2026. doi: 10.1186/s12886-026-05248-z.