Best IOL choice dependent upon 'balance,' surgeon says

NICE, France — With more than 1,300 available IOLs on the market, the "best" IOL for a patient is the one that balances essential properties most effectively in relation to the patient's functional visual requirements, said Olivia Serdarevic, MD, here at the European Society of Cataract and Refractive Surgeons meeting.

The five properties most imperative to a successful IOL implant are the handling/insertion qualities of the IOL, its capsular and uveal biocompatibility, its anatomic and refractive stability and the optical quality of the lens, she said.

"We as surgeons do not yet understand all the factors involved in biocompatibility," she said. Increasingly lately, emphasis has been placed on lens design for prevention of posterior capsular opacification.

"It is the square edge that really helps, regardless of whether it's an acrylic or silicone lens," Dr. Serdarevic said. A number of available IOLs incorporate the square posterior lens edge that seems to prevent epithelial cell proliferation and resulting PCO, she said.

"Keep in mind, edge design will affect patients with larger pupils more than your other patients," she cautioned.