https://doi.org/10.1177/1120672117752133 European Journal of Ophthalmology 1–6 © The Author(s) 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1120672117752133 journals.sagepub.com/home/ejo EJO European Journal of Ophthalmology Introduction During the past two decades, cataract surgery underwent tremendous changes and modernisation resulting in today’s small incision, phacoemulsification surgery and a safer technique with a shorter rehabilitation time for the patient. The most frequent long-term complication of cataract sur- gery remains to be posterior capsule opacification (PCO). In the past few years, refinements in surgical technique and modifications in intraocular lens (IOL) design and material have led to a decrease in the incidence of PCO. 1 Hydrophobic materials, such as silicone and hydrophobic acrylate, have been reported to achieve the lowest PCO rates especially when combined with a sharp posterior optic edge. 2–4 However, it is still a matter of controversy whether a hydrophilic acrylic IOL shows a similar PCO performance as compared to the well-tested hydrophobic acrylic materials. In addition, it has been shown that a sharp posterior optic edge inhibits migration of lens epi- thelial cells (LECs) behind the IOL optic resulting in a lower incidence of PCO. 5–7 The aim of this study was to evaluate the capsular bag performance and PCO development of two IOLs differing in material and design. Comparing capsular bag performance of a hydrophilic and a hydrophobic intraocular lens: A randomised two-centre study John Koshy 1 , Nino Hirnschall 1,2 , Ashok Kumar V Vyas 3 , R Narendran 3 , Alja Crnej 1 , Vinod Gangwani 1 , Yutaro Nishi 1 , Vincenzo Maurino 1 and Oliver Findl 1,2 Abstract Purpose: To evaluate the capsular bag performance and posterior capsule opacification development of two intraocular lenses differing in material and design. Methods: This study included patients who were scheduled for cataract surgery and compared a hydrophilic intraocular lens (Superflex ® intraocular lens; Rayner Surgical, Worthing, UK) with a hydrophobic intraocular lens (AcrySof ® SA60AT; Alcon, Fort Worth, TX, USA). Follow-ups were performed 1 month and 2 years after cataract surgery, including a slit lamp examination and retroillumination images. Results: In total, 80 eyes of 80 patients were recruited. At the 1-month follow-up, 6 of 39 cases had a gap between the posterior lens capsule and intraocular lens (1 case in the hydrophilic intraocular lens group and 5 cases in the hydrophobic intraocular lens group; p = 0.348). Objective and subjective posterior capsule opacification scoring showed no statistically significant difference between both groups (p = 0.123). Conclusion: Both intraocular lens showed a good capsular bag performance and a relatively low posterior capsule opacification development within the first 2 years after surgery. Keywords Superflex, intraocular lens, optic size Date received: 22 September 2017; accepted: 14 December 2017 1 Moorfields Eye Hospital NHS Foundation Trust, London, UK 2 VIROS – Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria 3 The Scarborough Hospital, Scarborough, UK Corresponding author: Oliver Findl, VIROS – Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Heinrich-Collin-Straße 30, 1140 Vienna, Austria. Email: oliver@findl.at 752133EJO 0 0 10.1177/1120672117752133European Journal of OphthalmologyKoshy et al. research-article 2018 Original Research Article