Purpose: We compared Scheimpflug anterior segment changes between 3 piece and aspheric 1-piece intraocular lens (IOLs) after uneventful phacoemulsification and implantation and assessed the impact of these changes on the postoperative intraocular pressure and refraction stability.
Methods: This prospective randomized comparative study included 76 phacoemulsification-treated eyes with senile cataracts. The eyes were randomized into 2 equal groups according to the type of IOL inserted: 3-piece (Acrysof MA60AC) or single piece aspheric IQ (Acrysof SN60WF). Scheimpflug (Sirius, CSO) imaging was used to measure preoperative and postoperative corneal volume at 10mm and anterior chamber depth, volume and angle. Intraocular pressure and postoperative refraction were also measured during the follow-up.
Results: The increase in the postoperative corneal volume, anterior chamber depth, volume and angle in both groups was statistically significant. The difference between the groups in the follow-up period were statistically non-significant. The postoperative refraction remained stable for patients receiving 1-piece implants but myopic shift occurred in those with 3-piece implants at 1 week to 1 month post operation. The intraocular pressure significantly reduced postoperatively but with a statistically nonsignificant difference between the groups.
Conclusion: After ineventful phacoemulsification, the corneal volume and anterior chamber depth, volume and angle increased significantly, with no difference between the 1- and 3- piece IOLs. The 3-piece acrylic IOL showed forward axial movement with myopic shift over the 3 month follow-up, while the 1-piece aspheric acrylic IOL showed little axial movement with more stable refraction. Eyeglasses can be prescribed with single piece IOLs than for those with 3-piece IOLs.