Effect of the hydrophilicity of acrylic intraocular lens material and haptic angulation on anterior capsule opacification.

Abstract

To evaluate the influence of hydrophilic and hydrophobic acrylic material and haptic angulation on anterior capsule opacification (ACO). Prospective study on 53 patients with bilateral age-related cataract. Patients underwent standard cataract surgery by the same surgeon and randomly received a hydrophilic acrylic intraocular lens (IOL) in one eye and a hydrophobic acrylic IOL in the other eye. Forty five of these patients completed the one-year follow-up. The following parameters were assessed: decentration, buttonholing, anterolenticular gap (ALG), ACO, outgrowth and refractive outcome. At the one-year follow-up, ACO was seen in 80% of the hydrophilic and 100% of the hydrophobic IOLs. ACO was more intense in the hydrophobic IOLs (p<0.001). Outgrowth was seen in 42% of the hydrophilic and 2% of the hydrophobic IOLs (p = 0.0003). No case of persisting ALG was seen in the hydrophobic IOLs, but in 42% of the hydrophilic IOLs. The refractive outcome was -0.29 (SD 0.56) dioptres for the hydrophilic and 0.003 (SD 0.44) dioptres for the hydrophobic IOLs (p<0.001). These results suggest that there is less ACO in hydrophilic acrylic than in hydrophobic acrylic IOLs. Although material properties might play a role, the angulated haptics of the hydrophilic IOLs exert an additional effect by the persisting ALG and a lack of contact between the IOL and the anterior capsule.