Membranous proliferation of lens epithelial cells on acrylic, silicone, and poly(methyl methacrylate) lenses

Abstract

Purpose: To determine whether intraocular lens (IOL) material influences the membranous proliferation of lens epithelial cells (LECs) on the anterior surface of the IOL. Setting: Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. Methods: This prospective study included 87 eyes of 87 consecutive patients who had cataract surgery with IOL implantation. Patients were randomly assigned to receive a single-piece poly(methyl methacrylate) (PMMA) IOL, a 3-piece silicone IOL, or a 3-piece acrylic IOL. Postoperatively, the IOL optic was examined by slitlamp microscopy at 1 and 10 days and 1, 2, and 3 months to determine the incidence, duration, and extent of membranous LEC proliferation. The optic was also examined at 6, 9, and 12 months if proliferation persisted. Results: Thirteen eyes were excluded from analysis because of incomplete coverage of the IOL rim by the anterior capsule margin; 74 remaining eyes were studied. All patients obtained good postoperative visual acuity (20/25 or better). Incidence ( P = .0024) and duration ( P = .0002) of membranous LEC proliferation with the acrylic IOL was greater than with the other 2 types. Proliferation on the acrylic IOL was more extensive than on the PMMA IOL 10 days postoperatively ( P < .05) and on the silicone IOL at 10 days ( P < .01) and 1 month ( P < .01). However, LEC proliferation on the 3 types of IOLs usually decreased by the third postoperative month, and proliferation did not disturb visual acuity. Conclusions: The material of an IOL influenced membranous proliferation of LECs on its anterior surface. Proliferation on the acrylic IOL persisted longer than on the other 2 types but did not cause visual symptoms.