BIOCOMPATIBILITY AND BLOOD-AQUEOUS BARRIER IMPAIRMENT IN AT-RISK EYESWITH HEPARIN-SURFACE-MODIFIED OR UNMODIFIED LENSES

Purpose: To evaluate the influence of heparin-surface-modified (HSM) v ersus unmodified poly(methyl methacrylate) (PMMA) intraocular lenses ( IOLs) on the blood-aqueous barrier (BAB) in at-risk eyes. Setting: Dep artment of Ophthalmology, Bundesknappschaft's Hospital, Sulzbach, Germ any. Methods: This study comprised 100 patients with predisposing risk factors for BAB destabilization (e.g., diabetes mellitus with or with out retinopathy, glaucoma, pseudoexfoliation, uveitis). One eye in eac h patient received an HSM IOL and the fellow eye, a conventional unmod ified PMMA IOL after phacoemulsification by the same surgeon. Anterior chamber flare was measured with the Kowa 500 laser flare meter 1 day before and 1 day, 1 and 6 weeks, and 3 months after surgery. Results: For most risk factors, mean flare was lower in the HSM group than in t he PMMA group at most follow-ups. Significantly lower flare values (di fference between postoperative and preoperative mean values) were seen in eyes with the HSM IOL at 6 weeks (P < .004) and 3 months (P < .003 ); Student's t-test). In the group with preoperative elevated flare va lues, the eyes with the HSM IOL had significantly better results 6 wee ks (P < .0006) and 3 months (P < .01) postoperatively. The values in t he HSM IOL eyes were also significantly higher in the diabetic with re tinopathy group at 3 months (P < .003). Conclusion: The results confir m the efficacy of IOL surface modification in reducing postoperative i ntraocular reaction in at-risk eyes.