Comparison of postoperative results after implantation of hydrophilic acrylic or hydrophobic acrylic intraocular lens: Data of one-year prospective clinical study

Abstract

Objective. To evaluate and compare the impact of two sharp-edge optic foldable intraocular lenses (IOLs) of similar design made from different material (hydrophilic acrylic or hydrophobic acrylic) on visual function, anterior and posterior capsule opacification at one-year follow-up after cataract phacoemulsification. Material and methods. Seventy-two eyes of 72 patients scheduled for cataract surgery were included in a prospective clinical study. Two foldable sharp-edge optic posterior chamber acrylic IOLs of similar design were used. Thirty-nine eyes of 39 patients received a single-piece hydrophilic acrylic (PC 511, Ophtec) IOL and 33 eyes of 33 patients – single-piece hydrophobic acrylic (AcrySof, SA60AT, Alcon) IOL. Visual acuity, anterior capsule opacification (ACO), capsulorrhexis/optic overlapping, and posterior capsule opacification (PCO) were evaluated. The intensity of ACO was assessed subjectively. PCO values in the entire IOL optic area and in the central 3-mm optic zone were assessed using a photographic image analysis system (EPCO 2000). The patients were examined at one year postoperatively. Results. There were no significant differences in best-corrected visual acuity and capsulorrhexis/optic overlapping between IOL types at 1-year follow-up after surgery. In the single-piece hydrophilic acrylic IOL group, the grade of ACO density was significantly higher in capsulorrhexis rim area (1.56±0.71 and 1.00±0.75) and in the capsule/optic area (1.62±0.67 and 1.00±0.75) (P<0.05). PCO values of the entire IOL optic area (0.12±0.13 and 0.024±0.02) as well as in the central 3-mm optic zone (0.06±0.11 and 0.001±0.003) was significantly higher in the single-piece hydrophilic acrylic IOL group one year postoperatively (P<0.05). In 33.3% of cases of the single-piece hydrophilic acrylic IOL group, contraction of haptics to IOL optics was present one year postoperatively, which was not present in any case of the single-piece hydrophobic acrylic IOL group. Conclusions. One-year follow-up after cataract surgery has shown a significant difference in ACO and PCO development comparing single-piece hydrophilic acrylic and single-piece hydrophobic acrylic intraocular lenses. The effect of hydrophobic acrylic foldable lenses on preventing anterior and posterior capsule opacification is mainly a result of the acrylic hydrophobic biomaterial.

Comparison of anterior capsule contraction between hydrophobic and hydrophilic intraocular lens models

“…These properties have been also linked with ACCS development, while hydrophobic IOLs appear to have better biocompatibility in terms of anterior capsule contraction syndrome and posterior capsular opacification [14,[25][26][27].…”

Special Cases in Cataract Surgery

“…Although hydrophilic acrylic material has better uveal biocompatibility, lower adhesion of bacteria and silicone oil, and less incidence of glare, its weak adhesion to type IV collagen leads to an increased incidence of fibrosis, which is more likely to lead to the occurrence of CCS [25][26][27]. The hydrophobic acrylate IOL can inhibit the migration of LEC to the optical zone and loops, thereby reducing the occurrence of CCS [22,28,29]. In this case, both eyes of the patient used hydrophilic acrylic IOL, which may also be one of the risk factors for the rapid occurrence of CCS.…”

Effects of Residual Anterior Lens Epithelial Cell Removal on Axial Position of Intraocular Lens after Cataract Surgery

“…Not proven in the Sensar IOL, hydrophobic acrylic has bioadhesive characteristics that enhance the adhesion of IOL to the capsular bag and leads to less proliferation of LECs and anterior and posterior capsule fibrosis, with successive alleviation of capsule contraction and optic movement [ 22 , 23 ]. Several studies have reported that anterior capsule contraction was significantly greater after hydrophilic IOL implantation than after hydrophobic IOL implantation [ 24 – 26 ]. We expect that more definite results may be found in further studies using hydrophilic acrylic IOLs instead of hydrophobic acrylic IOLs.…”