Adhesion of fibronectin, vitronectin, laminin, and collagen type IV to intraocular lens materials in pseudophakic human autopsy eyes - Part 1: Histological sections

Purpose: To evaluate fibronectin, vitronectin, laminin, and collagen type I V adhesion to poly(methyl methacrylate) (PMMA), silicone, hydrophobic soft acrylate, and hydrogel intraocular lenses (IOLs) in pseudophakic human auto psy eyes. Setting: Center far Research on Ocular Therapeutics and Biodevices, Storm E ye Institute, Medical University of South Carolina, Charleston, South Carol ina, USA. Methods: Thirty-eight autopsy eyes containing PMMA, silicone, hydrophobic a crylate, or hydrogel tilts were assessed. Histological sections were prepar ed from each eye, and immunohistochemical analyses were performed for fibro nectin, vitronectin, laminin, and collagen type IV. One hundred fifty-two s pecimens were analyzed. Results: A sandwich-like structure (anterior or posterior capsule/fibronect in/1 cell layer/fibronectin/IOL surface) was seen in 12 of 14 autopsy eyes with soft acrylate IOLs, 3 of 10 with a PMMA IOL (P =.0094), 1 of 10 with a silicone IOL (P =.0022), and 0 of 4 with a hydrogel IOL (P =.0041). The th icker fibrocellular tissue on the inner surface of the anterior or posterio r capsule that was in contact with silicone IOLs was lined with collagen ty pe IV. Vitronectin and laminin were not found at the fibrocellular tissue-I OL interface in any specimen. Conclusions: This study seems to confirm the sandwich theory of posterior c apsule opacification in eyes with an IOL and suggests that fibronectin may be the major extracellular protein responsible for the attachment of hydrop hobic soft acrylate (AcrySof(R)) IOLs to the capsular bag. This may represe nt a true bioactive bond between the IOL and lens epithelial cells or betwe en the IOL and the capsular bag and may be one reason the PCO and neodymium :YAG capsulotomy rates are lower in eyes with a soft acrylate IOL. J Catara ct Refract Surg 2000; 26:1792-1806 (C) 2000 ASCRS and ESCRS.