Comparison of the postoperative inflammatory response in the normal eye with heparin-surface-modified and poly(methyl methacrylate) intraocular lenses

• Published in: Journal of cataract and refractive surgery Vol. 21; no. 5; pp. 579 - 585
• Main Authors: Shah, Sanjay M., Spalton, David J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1995; Elsevier Science
• Subjects: Aged; Biocompatible Materials; Biological and medical sciences; blood-aqueous barrier; Blood-Aqueous Barrier - drug effects; Cell Count; Cell Survival; corneal endothelial cell loss; Double-Blind Method; Endothelium, Corneal - pathology; Female; Fluorophotometry; Giant Cells - pathology; Heparin - pharmacology; heparin surface modification; Humans; intraocular lens; intraocular lens surface cell deposit; laser flare cell meter; Lenses, Intraocular; Male; Medical sciences; Methylmethacrylates; Photography; poly(methyl methacrylate); Prospective Studies; Surface Properties - drug effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Treatment Outcome; Visual Acuity; fluorophotometry; intraocular lens surface cell deposit; poly(methyl methacrylate); intraocular lens; blood-aqueous barrier; heparin surface modification; corneal endothelial cell loss; laser flare cell meter; Human; Postoperative; Cataract; Anticoagulant; Inflammation; Anterior segment; Methyl acrylate polymer; Eye disease; Lens disease; Surgery; Biocompatibility; Glycosaminoglycan; Coating; Heparin; Intraocular lens; Comparative study
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/S0886-3350(13)80221-0

Evidence that poly(methyl methacrylate) (PMMA) is not inert in the eye has led to the introduction of intraocular lens (IOL) surface modification. In this prospective, double-blind, randomized study, we evaluated the effects of heparin surface modification (HSM) on anterior segment inflammation for one year after endocapsular cataract surgery. Fifty-four eyes were randomized to receive an HSM IOL (29 eyes) or a PMMA IOL (25 eyes) and were assessed postoperatively by corneal endothelial photography, laser flare and cell measurements, fluorophotometry, and IOL surface specular microscopy. Corneal endothelial loss, mean aqueous flare and cells, and fluorophotometry did not differ significantly between the groups, although fewer eyes in the HSM group had high flare values on the first postoperative day. The number of giant cells was significantly less in the HSM group for up to one year after surgery. Although there was no statistical difference in overall visual outcome, more patients in the HSM group (17%, 5/29) achieved a postoperative visual acuity of 20/15 than in the PMMA group (0). These results demonstrate that HSM enhances IOL biocompatibility and these effects are detectable in the low-risk, normal eye.