Adhesion of fibronectin, vitronectin, laminin, and collagen type IV to intraocular lens materials in pseudophakic human autopsy eyes - Part 2: Explanted intraocular lenses

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 human pseudophakic auto psy eyes. Setting: Center for Research on Ocular Therapeutics and Biodevices, Storm E ye Institute, Medical University of South Carolina, Charleston, South Carol ina, USA. Methods: Thirty-two autopsy eyes containing PMMA, silicone, soft acrylate, or hydrogel IOLs were assessed. The IOLs were explanted from the capsular b ag, and both sides of the IOLs were immunohistochemically stained for fibro nectin, vitronectin, laminin, or collagen type IV. The number of cells on t he IOL surfaces was counted. The capsular bag from 1 eye containing a soft acrylate IOL was examined for fibronectin and vitronectin. Results: Hydrophobic soft acrylate IOLs had Significantly more fibronectin adhering to their surfaces than PMMA (P <.01) or silicone (P <.01) IOLs, as well as more vitronectin. Silicone IOLs had more collagen type IV adhesion than the other IOLs (P <.05-.06). Collective protein adhesion differed sig nificantly between soft acrylate IOLs and PMMA and silicone IOLs, but not b etween PMMA and silicone IOLs. Conclusions: The greater amount of protein on the hydrophobic soft acrylate (AcrySof(R)) IOLs seems to support an adhesive mechanism for their attachm ent to the capsular bag. Fibronectin and vitronectin have functional domain s to bind them to lens epithelial cells and the collagenous capsule. This k ind of attachment could be a true-bioactive bond and may be 1 reason the PC O and neodymium:YAG capsulotomy rates are lower in eyes with a soft acrylat e IOL. J Cataract Refract Surg 2000;26: 1807-1818 (C) 2000 ASCRS and ESCRS.