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Outcomes in cataract surgery: high-cost versus low-cost single-piece hydrophobic intraocular lens implantation in phacoemulsification - a contralateral eye study

Poster Details

First Author: S.Basak INDIA

Co Author(s):    S. Mitra              

Abstract Details



Purpose:

Hydrophobic acrylic Intraocular lens (IOL) is gold standard in terms of material biocompatibility, safety and long-term outcomes. In India many companies are now manufacturing low-cost hydrophobic IOL which is relevant for the developing world. The purpose of this study was to compare the cost and outcomes of high-cost and low-cost hydrophobic single-piece IOL implantation in phacoemulsification.

Setting:

Disha Eye Hospitals & Research Centre, Kolkata, West Bengal; 700120, India.

Methods:

This was a prospective non-randomized contralateral eye study. 148 patients underwent sequential bilateral cataract surgery with a gap of 2- 4 weeks between two eyes. One eye (Group A) was with high-cost hydrophobic single-piece IOL (AcrySof SA60AT) and other eye (Group B) with a low-cost hydrophobic single-piece IOL (Aurovue; HP7600). All surgeries were performed by stop and chop technique by the same surgeon. Eye with any complication during surgery was excluded from this study. Follow up by a masked examiner after 1 week, 3 months, 12 months and 24 months for anterior chamber reactions; best spectacle corrected visual acuity (BSCVA), IOL centration; and incidence of posterior capsular opacification (PCO) at the end of 24 months follow-up. Cost of the IOL in each group was taken into account.

Results:

Two eyes in two patients had operative complications and excluded from this study. 146 patients were enrolled and all of them completed 1 week follow up. 140 (95.8%) patients completed 3 months, 120 (82%) completed 1 year and 101 (69.1%) patients completed 2 years follow-up. No significant difference was found between the two groups (p>0.05) in terms of anterior chamber reactions, BSCVA, amount in IOL decentration at 1 week and 3 months postoperative follow ups. Significant PCO with loss of two line occurred in 1 eye in Group A and 2 eyes in Group B after 1 year (P<0.05). At the end of two years 4 eyes in each group developed significant PCO with loss of two lines requiring YAG capsulotomy. The cost of high-cost hydrophobic IOL was 4.5 times higher (20 USD vs 92 USD) in Indian market.

Conclusions:

Low-cost single-piece hydrophobic IOL (Aurovue: HP7600) is a very good alternative to high-cost single-piece hydrophobic IOL (AcrySof: SA60AT) in terms of safety, anterior chamber reaction, IOL centration and postoperative visual outcomes. PCO formation is almost similar in both groups at the end of one and two years follow-up. When affordability is an issue, the phacoemulsification with HP7600 IOL is much more acceptable to the patient of developing world. FINANCIAL INTEREST: NONE

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