AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens(IOL)to determine risk factors of posterior capsule folds.

METHODS:It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification(PHACO)and IOL implantation and at least one of the three types of IOL was implanted, including 2-haptic 3-piece IOLs(HOYA PY60AD), 4-haptic 1-piece IOLs(Bausch & Lomb AO), 2-haptic 1-piece IOLs(AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient's age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis.

RESULTS: One hundred eighty-seven patients(242 eyes)had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch & Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs(56.3% vs 38.3%, P=0.027). While the incidence of patients implanted with Bausch & Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs(14.8% vs 38.3%, P=0.001). Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds \〖P=0.020, OR(95%CI)=2.145(1.129,4.073)\〗, while using Bausch & Lomb AO IOLs reduced the risk \〖P=0.001, OR(95%CI)=0.274(0.127, 0.591)\〗. Shorter ocular axis might increase the risk of posterior capsule folds \〖P=0.012, OR(95%CI)=0.669(0.489, 0.915)\〗.

CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch & Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.