Adhesion of lens capsule to intraocular lenses of polymethylmethacrylate, silicone, and acrylic foldable materials: an experimental study

AIMS To investigate the adhesion characteristics of several intraocular lenses (IOLs) to the simulated and rabbit lens capsule. METHODS Adhesive force to bovine collagen sheets was measured in water with polymethylmethacrylate (PMMA), three piece silicone, and acrylic foldable IOLs. In rabbit eyes, phacoemulsification and IOL implantation were performed. Three weeks later, adhesion between the anterior/posterior capsules and IOL optic was tested, and the capsule was examined histologically. RESULTS The mean adhesive force to the collagen sheet was 1697 (SD 286) mg for acrylic foldable, 583 (49) mg for PMMA, and 0 mg for silicone IOLs (p=0.0003, Kruskal–Wallis test). Scores (0–5) of adhesion between rabbit anterior capsule and IOL optic were 4.50 (0.55) for acrylic foldable, 3.20 (0.84) for PMMA, and 0.40 (0.55) for silicone IOLs (p=0.004). Scores between rabbit posterior capsule and IOL optic displayed a similar tendency; 4.50 (0.84) for acrylic foldable, 3.00 (1.00) for PMMA, and 0.40 (0.55) for silicone IOLs (p=0.021). Histological observation indicated that the edge of IOL optic suppressed the migration of lens epithelial cells towards the centre of the posterior capsule. This inhibitory effect was most pronounced with acrylic foldable IOL and least with silicone IOL. CONCLUSIONS The acrylic foldable IOL adhered to the lens capsule more than the PMMA IOL, and the silicone IOL showed no adhesiveness. These differences seem to play a role in preventing lens epithelial cells from migrating and forming posterior capsule opacification.

[1]  A. Gwon,et al.  Restoring lens capsule integrity enhances lens regeneration in New Zealand albino rabbits and cats , 1993, Journal of cataract and refractive surgery.

[2]  S. Soukiasian,et al.  Bisecting a foldable acrylic intraocular lens for explantation , 1996, Journal of cataract and refractive surgery.

[3]  P. Hill,et al.  Inhibition of Capsule Opacification by Convex Surface Posterior Three-Piece all-PMMA C-loop Lenses: A Fellow Eye and Same Lens Study , 1989 .

[4]  C. Zetterström,et al.  After‐cataract formation in newborn rabbits implanted with intraocular lenses , 1996, Journal of cataract and refractive surgery.

[5]  C. P. Born,et al.  Effect of intraocular lens optic design on posterior capsular opacification , 1990, Journal of cataract and refractive surgery.

[6]  R. Lindstrom,et al.  Management of the posterior capsule following posterior chamber lens implantation. , 1980, Journal - American Intra-Ocular Implant Society.

[7]  J. Cumming.  Capsulotomy Rate in Silicon Plate Haptic and Prolene Loop IOLs , 1994 .

[8]  S. Behrendt,et al.  Complications of silicone disc intraocular lenses , 1995, Journal of cataract and refractive surgery.

[9]  L. Oakford,et al.  Macromolecular organization of bovine lens capsule. , 1986, Tissue & cell.

[10]  A. Crandall,et al.  Neodymium:YAG capsulotomy rates after phacoemulsification with silicone posterior chamber intraocular lenses , 1996, Journal of cataract and refractive surgery.

[11]  A. Caporossi,et al.  Pathogenesis of posterior capsular opacification: Part I. Epidemiological and clinico‐statistical data , 1990, Journal of cataract and refractive surgery.

[12]  O. Nishi.  Incidence of posterior capsule opacification in eyes with and without posterior chamber intraocular lenses , 1986, Journal of cataract and refractive surgery.

[13]  A. T. Milauskas.  Posterior capsule opacification after silicone lens implantation and its management , 1987, Journal of cataract and refractive surgery.

[14]  T Nagamoto,et al.  Lens epithelial cell migration onto the posterior capsule in vitro , 1996, Journal of cataract and refractive surgery.

[15]  M. Mancini,et al.  In vitro production of glycosaminoglycans by retinal microvessel cells and lens epithelium. , 1986, Investigative ophthalmology & visual science.

[16]  F. O'Donnell,et al.  Comparative study of the effects of optic design on lens epithelium in vitro , 1987, Journal of cataract and refractive surgery.

[17]  J. McAvoy,et al.  The roles of laminin and fibronectin in the development of the lens capsule. , 1991, Current eye research.

[18]  U. Stenevi,et al.  Effect of a plano‐convex posterior chamber lens on capsular opacification from Elschnig pearl formation , 1988, Journal of cataract and refractive surgery.

[19]  T. Neuhann.  Intraocular folding of an acrylic lens for explantation through a small incision cataract wound , 1996, Journal of cataract and refractive surgery.

[20]  L. Artaria,et al.  Evaluation of the first 50 ACR360 acrylic intraocular lens implantations , 1996, Journal of cataract and refractive surgery.

[21]  T. Oshika,et al.  Two year clinical study of a soft acrylic intraocular lens , 1996, Journal of cataract and refractive surgery.

[22]  D. Kurosaka,et al.  Effect of intraocular lens design on posterior capsule opacification after continuous curvilinear capsulorhexis , 1995, Journal of cataract and refractive surgery.

[23]  G. Vrensen,et al.  The pathology of after‐cataract , 1992 .

[24]  Y. Yamada,et al.  Efficacy of equator rings in an experimental rabbit study. , 1995, A M A Archives of Ophthalmology.

[25]  L. Corydon,et al.  Posterior capsule fibrosis and intraocular lens design , 1988, Journal of cataract and refractive surgery.

[26]  T. Wood,et al.  Effect of intraocular lens convexity on posterior capsule opacification , 1986, Journal of cataract and refractive surgery.

[27]  H. Hayashi,et al.  Capsular capture of silicone intraocular lenses , 1996, Journal of cataract and refractive surgery.