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Anterior capsular opacification tied to IOL material

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IOL material properties may affect the incidence of anterior capsular opacification, according to a clinical study. The study found the lowest presence of anterior capsular opacification on hydrophobic acrylic IOL, in comparison to hydrophilic acrylic and silicone IOLs.

Daniele Tognetto, MD, and colleagues with the University of Trieste (Italy) randomized 88 cataract patients to receive one of four types of foldable IOL after phacoemulsification. Twenty-five of the patients were implanted with the Storz Hydroview H60M, 24 with the Corneal ACR6D, 18 with the AMO SI40NB and 21 with the Alcon AcrySof MA60BM. Postoperative examinations in intervals out to 2 years follow-up included ophthalmologic exams, slit-lamp biomicroscopy and photography using red reflex and focal illumination of the anterior IOL surface. Main outcome measures included best corrected visual acuity and subjective grading of anterior capsular opacification and membrane growth on the anterior IOL surface.

All surgeries were uneventful, and all patients received the same preoperative and postoperative treatment. Six patients who did not complete the follow-up were excluded from the study.

Fibrosis of the anterior capsule was more frequently observed in patients implanted with the Corneal ACR6D and AMO SI40NB lenses. The Hydroview and the ACR6D groups showed a higher percentage of cases with membrane growth from the capsulorrhexis edge onto the anterior IOL surface. The group implanted with the AcrySof showed the lowest presence of fibrosis of the anterior capsule, and no membrane growth was noted in these patients.

“This study has revealed the presence of both severe ACO and membrane outgrowth in Corneal IOLs,” the study authors said. “This finding demonstrates that different hydrophilic materials can cause a specific LEC reaction. The definition of a material as hydrophilic is no longer sufficient to describe the biocompatibility of an IOL.”

The natural location of lens epithelial cells precludes the possibility of IOL design influencing anterior capsule behavior, the study authors added.

The study is published in the October issue of Ophthalmology.