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Effect of the hydrophilicity of acrylic intraocular lens material and haptic angulation on anterior capsule opacification
  1. Lorenz Vock (lorenz.vock{at}meduniwien.ac.at),
  2. Michael Georgopoulos (michael.georgopoulos{at}meduniwien.ac.at),
  3. Thomas Neumayer (thomas.neumayer{at}meduniwien.ac.at),
  4. Wolf Buehl (wolf.buehl{at}meduniwien.ac.at),
  5. Oliver Findl (oliver.findl{at}meduniwien.ac.at)
  1. Medical University of Vienna, Austria
  2. Medical University of Vienna, Austria
  3. Medical University of Vienna, Austria
  4. Medical University of Vienna, Austria
  5. Medical University of Vienna, Austria

    Abstract

    Aim: To evaluate the influence of hydrophilic and hydrophobic acrylic material and haptic angulation on anterior capsule opacification.

    Methods: Prospective study on 53 patients with bilateral age-related cataract. Patients underwent standard cataract surgery by the same surgeon and randomly received a hydrophilic acrylic IOL in one eye and a hydrophobic acrylic IOL in the fellow eye. Forty- five of these patients completed the one-year follow-up. The following parameters were assessed: decentration, buttonholing, antero-lenticular gap (ALG), anterior capsule opacification (ACO) intensity and pattern, outgrowth and refractive outcome.

    Results: At the one-year follow-up, ACO was seen in 80% of the hydrophilic and 100% of the hydrophobic IOLs. ACO was more intense in the hydrophobic IOLs (p<0.001). Diffuse ACO occurred in 33% of the hydrophilic and 87% of the hydrophobic IOL (p<0.001). ACO of the rhexis-edge (33% hydrophilic and 13% hydrophobic) was not significantly different between the groups. Outgrowth was seen in 42% of the hydrophilic and 2% of the hydrophobic IOLs (p=0.0003). No case of persisting ALG was seen in the hydrophobic, but in 42% of the hydrophilic IOLs. The refractive outcome was- 0.29±0.56 D for the hydrophilic and 0.003± 0.44 D for the hydrophobic IOLs (p<0.001).

    Conclusion: These results suggest that there is less ACO in hydrophilic acrylic than in hydrophobic acrylic IOLs. While material properties might play a role, the angulated haptics of the hydrophilic IOLs exert an additional effect via the persisting ALG and a lack of contact between the IOL and the anterior capsule.

    • ACO
    • acrylic intraocular lens
    • anterior capsule opacification
    • haptic angulation
    • hydrophilic acrylic IOL

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