Biocompatibility Of Acrylic Intraocular Lenses In Eyes With Pseudoexfoliation Syndrome - Aspira- Aa Vs Acrysof S A60 A T – One Year Follow Up.

To compare uveal and capsular biocompatibility of hydrophilic acrylic Aspira-aA and hydrophobic acrylic AcrySof SA60AT intraocular lenses in eyes with pseudoexfoliation syndrome (PEX).

Department of Diagnostics and Microsurgery of Glaucoma, Medical University, Lublin, Poland

In this prospective study, 152 eyes of 148 patients with senile cataract (76 eyes with PEX, 76 non-PEX (N)) were enrolled. Patients were divided into four groups: Aspira-PEX (n=39 eyes; mean age=78 ± 6.35 years), Aspira-N (n=40 eyes; mean age=75 ± 8.23 years), SA60AT-PEX (n=37 eyes; mean age=77 ± 7.24 years) and SA60AT-N (n=36 eyes; mean age=73 ± 8.92 years). Eyes were examined 7 days, 3 months and 1 year after surgery. The amount of central and peripheral PCO (score 0-4), rhexis edge and entire capsule ACO (score 0-3), LEC outgrow (score 0-3), presence of cells on the IOL surface and laser flare tyndalometry (FM-500, Kowa) were assessed.

One year postoperatively, subjective central and peripheral PCO scores were not statistically different between all groups. Rhexis edge ACO scores were higher in PEX groups compared to controls with statistically higher scores in the SA60AT-PEX group. Entire capsule ACO scores were higher in PEX groups similar for both lenses. LEC ongrowth onto IOL surface was almost only found with the AcrySof lens. The presence of small round cells on the IOL surface was higher in SA60AT-PEX:48.6%vsAspira-PEX:7.7%(p<0.000). Foreign-body giant cells were found after 12 months on AcrySof lenses only (SA60AT-PEX:16.2%;SA60AT-N:19.4%). Laser flare results were significantly lower in the Aspira-PEX eyes vs AcrySof-PEX eyes.

Evaluated acrylic IOLs - Aspira-aA and AcrySof SA60AT - have good biocompatibility both in eyes with and without pseudoexfoliation. In terms of uveal biocompatibility, the inflammatory reaction one year after surgery was smaller in the Aspira-aA groups, especially in eyes with PEX. In terms of capsular biocompatibility, PCO results after 1 year were low in all groups, but ACO outcomes were higher in PEX eyes in both IOL models.

LEC outgrowth from the capsulorhexis towards the IOL anterior surface was almost exclusively found on AcrySof SA60AT IOLs, which show that LEC outgrowth is mainly material dependent.