Ej. Hollick et al., Surface cytologic features on intraocular lenses - Can increased biocompatibility have disadvantages?, ARCH OPHTH, 117(7), 1999, pp. 872-878
Objective: To compare the anterior surface cytologic features and effect on
blood-aqueous barrier of polymethyl methacrylate, silicone, and hydrogel i
ntraocular lens (IOL) implants to give an indication of their biocompatibil
ity.
Methods: This prospective study was performed at an English-teaching hospit
al. Ninety eyes were randomized to receive a polymethyl methacrylate, silic
one, or hydrogel implant. A standardized surgical protocol was performed by
a single surgeon using phacoemulsification. Patients were seen at interval
s for 1 year. Measurements of visual acuity, contrast sensitivity, and ante
rior chamber laser flare and cells were obtained: and an assessment of lens
cytologic features using specular microscopy of the anterior IOL surface w
as performed.
Results: Visual acuity and contrast sensitivity were not significantly diff
erent among the 3 groups. Hydrogel IOLs were associated with fewer inflamma
tory cells on their surface than polymethyl methacrylate and silicone IOLs
(P<.001), but with significantly more lens epithelial cells (LECs) (P<.001)
. Patients with hydrogel implants without LECs had greater blood-aqueous ba
rrier breakdown than those with LECs.
Conclusions: The hydrogel IOLs were associated with a reduced inflammatory
cell reaction but had many more LECs on their anterior surface. Those IOLs
associated with increased blood-aqueous barrier damage did not develop LECs
. if an IOL is too biocompatible, then it may incite the growth of LECs ove
r its surface, which could have disadvantages.