Biocompatibility and blood-aqueous barrier impairment in at-risk eyes with heparin-surface-modified or unmodified lenses

Abstract

Purpose: To evaluate the influence of heparin-surface-modified (HSM) versus unmodified poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) on the blood-aqueous barrier (BAB) in at-risk eyes.Setting: Department of Ophthalmology, Bundesknappschaft's Hospital, Sulzbach, Germany.Methods: This study comprised 100 patients with predisposing risk factors for BAB destabilization (e.g., diabetes mellitus with or without retinopathy, glaucoma, pseudoexfoliation, uveitis). One eye in each patient received an HSM IOL and the fellow eye, a conventional unmodified PMMA IOL after phacoemulsification by the same surgeon. Anterior chamber flare was measured with the Kowa 500 laser flare meter 1 day before and 1 day, 1 and 6 weeks, and 3 months after surgery.Results: For most risk factors, mean flare was lower in the HSM group than in the PMMA group at most follow-ups. Significantly lower flare values (difference between postoperative and preoperative mean values) were seen in eyes with the HSM IOL at 6 weeks (P < .004) and 3 months (P < .003; Student's t-test). In the group with preoperative elevated flare values, the eyes with the HSM IOL had significantly better results 6 weeks (P < .0006) and 3 months (P < .01) postoperatively. The values in the HSM IOL eyes were also significantly higher in the diabetic with retinopathy group at 3 months (P < .003).Conclusion: The results confirm the efficacy of IOL surface modification in reducing postoperative intraocular reaction in at-risk eyes.