Anterior segment parameters: Comparison of 1-piece and 3-piece acrylic foldable intraocular lenses

Purpose: To compare anterior segment parameters between 1-piece and 3-piece acrylic foldable intraocular lenses (IOLs). Setting: Farabi Eye Hospital, Tehran, Iran. Design: Prospective randomized comparative case series. Method: Eyes scheduled for phacoemulsification were randomized into 2 equal groups to receive a 1-piece (AcrySof SA60AT) or 3-piece (AcrySof MA60AC) foldable acrylic IOL. Scheimpflug imaging (Pentacam) was used to measure anterior segment parameters, including anterior chamber depth (ACD), anterior chamber angle (ACA), and anterior chamber volume (ACV), preoperatively and 1 week and 3 months postoperatively. Results: The study evaluated 125 eyes (123 patients). There was a statistically significant postoperative increase in ACD, ACA, and ACV at 1 week and 3 months in both IOL groups. Although the mean ACD was significantly higher in the 3-piece group at 1 week, there was no significant between-group difference in ACD, ACA, or ACV at 3 months. There was no significant change in anterior segment parameters from 1 week to 3 months in the 1-piece group; however, the 3-piece group had statistically significant decreases in ACD, ACA, and ACV. Refraction remained stable throughout the follow-up in the 1-piece group but showed a significant myopic shift from 1 week to 3 months in the 3-piece group. Conclusions: After phacoemulsification, the 1-piece acrylic foldable IOL showed little axial movement and provided stable refraction throughout the follow-up. The 3-piece IOL had significant forward movement and led to a myopic shift within 3 months postoperatively. Results indicate that spectacles can be prescribed earlier in eyes with a 1-piece IOL.