Purpose: Condensation occurs rapidly on silicone intraocular lenses (IOLs) after vitrectomy and fluid-air exchange in the presence of a posterior capsulotomy, severely limiting the retinal view. Foldable IOLs made of an acrylic polymer are now available. The authors compare the condensation and subsequent retinal view degradation after vitrectomy and fluid-air exchange in rabbit eyes implanted with polymethylmethacrylate (PMMA), soft acrylic polymer (ACRYSOF), and silicone IOLs.
Methods: Thirty rabbits underwent bilateral lens removal. Twenty PMMA, 20 acrylic polymer, and 20 silicone IOLs were implanted into the capsular bag. After three-port vitrectomy, eyes were randomly assigned to undergo a posterior capsulotomy or to an intact posterior capsule. Fluid-air exchange was performed, and the amount of condensation on the IOL surface and resultant retinal view was graded. Surgical maneuvers then were performed to decrease the condensation. These maneuvers included wiping the IOL surface with a soft-tipped cannula and coating it with viscoelastic.
Results: No condensation occurred on IOLs in eyes with an intact posterior capsule. Significantly more condensation occurred on IOLs in eyes with a capsulotomy, regardless of IOL type (P < 0.014). Wiping the condensation resulted in significantly less condensation and improved retinal view on the PMMA and acrylic IOLs when compared with the silicone IOLs (P < 0.024). Condensation was eliminated on all three IOL types after viscoelastic was applied. However, increased distortion of the retinal view was induced by the viscoelastic on the silicone IOL as compared with the other IOLs.
Conclusions: Condensation and subsequent retinal image degradation occurs uniformly after vitrectomy, posterior capsulotomy, and fluid-air exchange in eyes with PMMA, acrylic, and silicone IOLs. Because the condensation can be eliminated most easily on acrylic IOLs compared with silicone IOLs, when foldable IOL techniques are used it is likely that an acrylic polymer IOL would be advantageous for those patients at risk for future vitreous procedures requiring fluid-air exchange.