Effect of optic edge design and haptic angulation on postoperative intraocular lens position change Vanessa Petternel, MD, Rupert Menapace, MD, Oliver Findl, MD, Barbara Kiss, MD, Matthias Wirtitsch, MD, Georg Rainer, MD, Wolfgang Drexler, PhD Purpose: To assess the effect of optic edge design and optic–haptic angulation of open-loop intraocular lenses (IOLs) on postoperative axial movement and the final position of the optic by measuring the anterior chamber depth (ACD) during the first postoperative year using partial coherence interferometry (PCI). Setting: Department of Ophthalmology, Vienna General Hospital, Institute of Med- ical Physics, University of Vienna, Vienna, Austria. Methods: In study 1, a 3-piece silicone IOL with nonangulated modified C-loop haptics (MicroSil, Dr. Schmidt) was implanted in 78 eyes of 39 patients; patients were randomized to receive a round-edged optic IOL in 1 eye and a sharp-edged optic IOL in the other eye. The ACD was measured by PCI 1 day, 1 week, 3 months, and 1 year after surgery. In study 2, a foldable, 3-piece acrylic IOL with modified 10-degree angulated J-loop haptics (AcrySof MA60BM, Alcon) was im- planted in 32 eyes of 32 patients. The ACD was measured by PCI 1 day, 1 week, and 3 months after surgery. Results: In eyes with a nonangulated silicone IOL, there was a significant postop- erative change in ACD with both sharp-edged and round-edged designs (P.01). There was forward movement of both IOL designs in the first week, with no sig- nificant difference between the 2 models. From 1 week to 3 months, there was backward movement of IOLs of both designs, with the sharp-edged IOL moving a significantly greater amount (P.001). From 3 months to 1 year, IOLs with both optic edge designs moved slightly backward. Sixty-six percent of angulated IOLs showed continuous but variable forward movement and 34%, backward movement. Conclusions: Optic edge design influenced postoperative axial optic movement and thus had an impact on the development of postoperative refraction (refractive shift, deviation from target refraction). The influence of optic–haptic angulation proved to be significantly greater and more variable than edge design. J Cataract Refract Surg 2004; 30:52–57  2004 ASCRS and ESCRS refractive surprises) remain a major problem of modern D espite the achievements in standardizing surgical cataract surgery. In addition to IOL tilt and decentra- technique, developing better intraocular lens tion, differences in postoperative axial optic movement (IOL) power calculation formulas and more precise and the final position of the optic (effective lens position biometry techniques, and improving the accuracy of [ELP]) are the major contributing factors to this phe- IOL power, deviations from the target refraction (ie, nomenon. 1 Postoperative forward movement of the IOL away from the retina produces myopia, while posterior movement toward the retina causes hyperopia. These axial movements reflect the interplay between capsular Accepted for publication May 30, 2003. bag fusion, the fibrotic reaction of the capsular bag after Reprint requests to Oliver Findl, MD, Department of Ophthalmology, IOL implantation, and the mechanical resilience of the University of Vienna, Wa ¨hringer Gu ¨rtel 18-20, 1090 Vienna, Austria. E-mail: oliver.findl@akh-wien.ac.at. IOL in withstanding the contracting forces. Thus, IOL  2004 ASCRS and ESCRS 0886-3350/03/$–see front matter Published by Elsevier Inc. doi:10.1016/S0886-3350(03)01020-4