The Relationship between the Adhesion Characteristics of Acrylic Intraocular Lens Materials and Posterior Capsule Opacification

Abstract

Purpose: To investigate the relationship between the adhesion characteristics of similarly designed hydrophobic acrylic intraocular lenses (IOLs) and posterior capsule opacification (PCO). Methods: Three similarly shaped hydrophobic acrylic IOLs with a sharp-edged optic were used. Adhesive force of IOLs was measured with a tackiness tester. Human lens epithelial cells (LECs) were grown on each IOL for 48 h. LECs were then stained with crystal violet, which served as an index of the amount of cells attached to IOLs. Cellular migration and proliferation assays were performed using chamber inserts containing a collagen membrane. After 96 h of incubation, the collagen membranes were stained with hematoxylin and eosin for analysis. Three similarly shaped IOLs were implanted in rabbits. The eyes were enucleated 3 weeks later and analyzed for PCO area. Results: Hydrophobic acrylic IOLs were classified into three groups: A (less adhesive), B (moderately) and C (highly). The migration area of LECs on the collagen membrane was 5.65 ± 4.5% in group A, 2.83 ± 2.1% in group B, and 1.41 ± 1.5% in group C, with a significant difference between groups A and C (p < 0.05). The mean percentage area of PCO in the rabbit eye was 19.4 ± 16.7% in group A, 17.5 ± 8.5% in group B, and 5.5 ± 3.8% in group C, with a significant difference between groups A and C (p < 0.05). Conclusion: Adhesive force of hydrophobic acrylic IOLs may play an important role in preventing PCO. Among the similarly shaped hydrophobic acrylic IOLs, IOLs of highly adhesive material inhibited LEC migration and PCO more than IOLs of less adhesive material.

Hydrophobic versus double-square-edged hydrophilic foldable acrylic intraocular lens: Effect on posterior capsule opacification

“…The hydrophobic acrylate surface has bioadhesive characteristics that improve adhesion of the IOL to the capsular bag and thus result in less PCO. 33,34 The biofilm formation on the Meridian HP60M hydrophilic IOL was less than that reported for PMMA IOLs and hydrophobic IOLs. 10 The reason may be the formation of a monolayer of LECs, which bonds the bioactive hydrophobic acrylic IOL to the posterior lens capsule.…”

Analysis of intraocular lens surface adhesiveness by atomic force microscopy

“…Fibronectin was also found to adhere more to hydrophobic acrylic IOLs than to PMMA, silicone, or hydrophilic acrylic IOLs. 48,49 Another consideration is that IOLs of the same material from different manufacturers can have different surface properties. Using 3 hydrophobic acrylic IOLs, Katayama et al 49 showed how the adhesiveness of disk optics of the same material and design from a single manufacturer can change significantly because of differences in the surface energy caused by modification of the constituents of the copolymer.…”

“…It is well known that modifying the surface energy of the IOL optic can influence the adhesiveness of the material. 49,50,51 Further AFM studies that directly compare hydrophobic acrylic IOLs from different manufacturers are needed to confirm this.…”

Selection of Intraocular Lenses in Patients With Uveitis

“…32 The adhesive force of lens material also influences PCO development-the more highly adhesive hydrophobic lens materials seem to inhibit lens epithelial cell migration. 33 Other important factors in limiting PCO formation include surgical technique, capsulorhexis overlap of the optic, and control of inflammation.…”