Calcification Of Intraocular Lenses Research Articles

A Bayesian semiparametric regression model for current status data

In survival analysis, interval censoring case I or current status censoring happens if each subject is observed only once for status of occurrence of the event of interest. Current status data often appear along with covariates in cross sectional studies and tumorigenicity studies. Cox’s proportional hazards model has been widely used to explore the relationship between lifetime variable and covariates. In this paper we propose a novel and easy to implement Bayesian approach for analyzing current status data. Under proportional hazards model, baseline survival function and regression parameters are estimated assuming proper prior distributions and implementing Metropolis Hastings algorithm for posterior computation. Methods for both model selection and model validation are suggested. Finite sample performance of the proposed method is evaluated using simulation studies. Intraocular lenses calcification data are analyzed for illustration.

Differential Diagnosis of Changes in Intraocular Lenses.

Differentiating between various intraocular lens (IOL) changes can be a challenge. In particular, certain IOL models carry the risk of late postoperative calcification. A major cause of IOL exchange surgery could be avoided if appropriate modifications were made during the IOL manufacturing process. The use of a hydrophilic acrylate carries the risk of IOL calcification, especially when a secondary procedure, such as a pars plana vitrectomy or other procedures using gas or air, is performed. In secondary IOL calcification, there is a wide range of opacification patterns, which are usually located in the centre on the anterior surface of the IOL or sometimes elsewhere. Often, granular deposits accumulate just below or on the surface of the IOL, leading to significant deterioration in visual quality and eventually requiring IOL exchange surgery. Therefore, in the case of eyes requiring secondary surgical intraocular intervention in the future, the use of hydrophilic IOLs should be critically evaluated. With regard to hydrophobic IOL materials, there are clear differences in the susceptibility to the formation of glistenings. Over time, there has been a significant decrease in glistening formation over the past 30years due to optimisation of the material. With hydrophobic IOLs, special care should also be taken to avoid mechanical damage. In general, the only treatment option for functionally-impairing IOL opacification is surgical lens exchange, which carries potential risks of complications. In cases with a low degree of functional impairment, and especially in eyes with additional ocular diseases, it may be difficult to weigh the risk of additional surgery against the potential benefit. In some cases, it may be more appropriate not to perform an IOL exchange despite the IOL opacification. Recent visualisation methods that allow high-resolution analysis of the opacities in vivo and in vitro may be used in the future to estimate the functional effects of various IOL material changes on the optical quality.

Opacification of Hydrophilic Acrylic Intraocular Lenses: Overview of Laboratory Methods for Histological Analysis and Replication of IOL Calcification.

Opacification of intraocular lenses (IOLs) due to material changes is a serious complication that can compromise the good visual outcomes of uncomplicated cataract surgery. In hydrophobic acrylic IOLs, opacification can result from glistening formation, while in hydrophilic acrylic IOLs, there is a risk of calcification due to the formation of calcium phosphates within the polymer. Over time, various methods have been developed to investigate calcification in hydrophilic acrylic IOLs. The aim of this article is to provide an overview of standard histological staining and models used to simulate IOL calcification. Histological staining can be used to detect calcification and assess the extent of crystal formation. The development of in vivo and in vitro replication models has helped to identify the underlying pathomechanisms of calcification. In vivo models are suitable for assessing the biocompatibility of IOL materials. Bioreactors as an in vitro model can be used to investigate the kinetics of crystal formation within the polymer. The replication of IOL calcification under standardized conditions using electrophoresis allows for the comparison of different lens materials with respect to the risk of calcification. The combination of different analytical and replication methods can be used in the future to further investigate the pathomechanisms of calcium phosphate crystal formation and the influence of risk factors. This may help to prevent calcification of hydrophilic acrylic IOLs and associated explantation and complications.

Clinical Characteristics of Patients with Intraocular Lens Calcification after Pars Plana Vitrectomy.

To determine the clinical risk factors that may increase the occurrence of intraocular lens (IOL) calcification in patients who had undergone pars plana vitrectomy (PPV). The medical records of 14 patients who underwent IOL explantation due to clinically significant IOL opacification after PPV were reviewed. The date of primary cataract surgery, technique and implanted IOL characteristics; the time, cause and technique of PPV; tamponade used; additional surgeries; the time of IOL calcification and explantation; and IOL explantation technique were investigated. PPV had been performed as a combined procedure with cataract surgery in eight eyes and solely in six pseudophakic eyes. The IOL material was hydrophilic in six eyes, hydrophilic with a hydrophobic surface in seven eyes and undetermined in one eye. The endotamponades used during primary PPV were C2F6 in eight eyes, C3F8 in one eye, air in two eyes and silicone oil in three eyes. Two of three eyes underwent subsequent silicone oil removal and gas tamponade exchange. Gas in the anterior chamber was detected in six eyes after PPV or silicone oil removal. The mean interval between PPV and IOL opacification was 20.5 ± 18.6 months. The mean BCVA in logMAR was 0.43 ± 0.42 after PPV, which significantly decreased to 0.67 ± 0.68 before IOL explantation for IOL opacification (p = 0.007) and increased to 0.48 ± 0.59 after the IOL exchange (p = 0.015). PPV with endotamponades in pseudophakic eyes, particularly gas, seems to increase the risk for secondary IOL calcification, especially in hydrophilic IOLs. IOL exchange seems to solve this problem when clinically significant vision loss occurs.

Novel exploration of ions and fatty acids in hydrophilic acrylic intraocular lens calcification.

To conduct a novel exploration and analysis of the ion and fatty acid levels of a medium in which calcified hydrophilic intraocular lenses (IOLs) are present. Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China. Retrospective, laboratory observational case series. Eleven patients (11 eyes) who had implantation of foldable hydrogel posterior IOLs were found to have opacification of the IOLs. In vivo and in vitro analyses included the evaluation of patients' clinical characteristics, microscopy, histological staining, energy dispersive X-ray spectroscopy (EDS), the ion level of the aqueous humor (AH) and preserving fluid (PF), and the fatty acid content of AH. Ten of 11 cases were female with unilateral opacification, and seven cases had both-eye cataract surgery, including 1 first eye and 6 second eyes with IOL opacification. Four types of similar serial numbers were counted. The analysis of AH showed that the concentrations of phosphorus and silicon were elevated but that of calcium decreased, and an increased level of silicon was detected in three random PFs. The palmitic (C16:0) and stearic (C18:0) fatty acids were higher than the others in the AH. The EDS confirmed that the IOL surface deposits were composed of calcium, phosphate, and a small amount of silicon. More silicon and higher C16:0 and C18:0 were found in the AH of patients with IOL opacification. New ideas and avenues have been proposed in the study of IOL opacification.

Intraocular Lens Calcification After Pseudophakic Endothelial Keratoplasty

To determine the incidence and to document risk factors for intraocular lens (IOL) calcification after pseudophakic endothelial keratoplasty. We retrospectively studied 2700 consecutive penetrating, anterior lamellar and endothelial keratoplasties carried out between December 1992 and June 2022 at the National Eye Hospital, Paris, France. Retrospective cohort study. All IOL calcification cases were associated with endothelial keratoplasty. Out of 588 endothelial keratoplasty procedures, 576 eyes were pseudophakic at the end of surgery. Fourteen cases of IOL calcification were observed during follow-up. The cumulative incidence of IOL calcification after endothelial keratoplasty was 4.5%±1.3% at 60 months. Hydrophilic acrylic IOL material (P < .001) and use of SF6 for anterior chamber tamponade (P=.001) were significantly and independently associated with the cumulative incidence of IOL calcification. The incidence of IOL calcifications seems to be around 5%. Ophthalmologists should avoid hydrophilic acrylic IOLs in patients with endothelial disorders. When the patient already has a hydrophilic IOL, SF6 should be avoided. The only effective treatment is IOL exchange.

Development of a standardized in vitro model to reproduce hydrophilic acrylic intraocular lens calcification

Opacification through calcification of hydrophilic acrylic intraocular lenses (IOL) is a severe complication after cataract surgery. Causing symptoms that range from glare through to severe vision loss, the only effective therapy is explantation of the opacified IOL so far. Although IOL calcification is a well-described phenomenon, its pathogenesis is not fully understood yet. The purpose of the current study was to develop a laboratory model to replicate IOL calcification. Calcification could be reproduced using a horizontal electrophoresis and aqueous solutions of calcium chloride and disodium hydrogen phosphate. The analysis of the in vitro calcified IOLs was performed using light microscopy, Alizarin Red and Von Kossa staining, scanning electron microscopy, energy dispersive x-ray spectroscopy and electron crystallography using transmission electron microscopy and electron diffraction. The presented laboratory model could be used to identify hydrophilic IOLs that are at risk to develop calcification and to assess the influence of associated risk factors. In addition, it can serve as a research tool to further understand this pathology.

Combined primary and secondary calcification of intra-ocular lenses

Combined primary and secondary calcification of intra-ocular lenses

Multifocal IOL explantation in patients with opaque lentis after refractive lens exchange.

We describe the outcomes of intraocular lens (IOL) explantation in a cluster of opaque multifocal Lentis LS-313 following refractive lens exchange (RLE). Single-centre, single-surgeon, retrospective case series. The study enrolled 10 eyes of 10 patients, 6 male and 4 female. All patients had uneventful RLE with multifocal IOL implantation. The mean patient age at the time of RLE was 53years ± 2.52 (SD). Two eyes had YAG laser capsulotomy prior to explantation. The mean interval between the initial RLE and IOL explantation was 5.4years ± 1.4 (SD). IOL exchange was performed in all eyes in one procedure. Five eyes had in the bag hydrophobic acrylic IOL (3 multifocal and 2 monofocal), three eyes had 3-piece hydrophobic acrylic IOL in the ciliary sulcus and two had an anterior chamber IOL. Intraoperatively one patient had weak zonules and two patients had zonular dehiscence and required anterior vitrectomy. The mean preoperative CDVA was 0.25 ± 0.15 (SD) logMAR and at the final follow-up, improved to 0.00 ± 0.07 (SD) logMAR (p < 0.01). Light microscopy with von Kossa stain confirmed IOL calcification. No postoperative complications were recorded. IOL exchange appears to be a feasible and safe surgical option for multifocal IOL opacification. However, patients must be warned of additional intraoperative risks including zonular dialysis, vitreous loss, retinal detachment and need for potential scleral or iris fixated IOL or anterior chamber IOL (ACIOL) with its associated sequel of complications. Moreover, YAG laser capsulotomy should be considered carefully as it increases the chances of intraoperative complications and restricts the surgical options of secondary IOL insertion such as in-the-bag IOL exchange with MFIOL.

Safety and efficacy of A1-UV aspheric intraocular lens implantation over the postoperative 5 years

Objective: To evaluate the clinical safety and efficacy of A1-UV aspheric intraocular lens (IOL) implantation over the postoperative 5 years. Methods: Prospective cohort study. The subjects came from a finished multicenter, randomized and controlled clinical trial with a follow-up period of 1 year from April to November 2012. The clinical research centers were Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Peking University Third Hospital, Tianjin Medical University Eye Hospital, and Daping Hospital of Army Medical University. Cataract patients in the experimental group were implanted with A1-UV type IOL, while cataract patients in the control group were implanted with SN60WF type IOL, and monocular patients were enrolled. From April to May 2018, patients enrolled in the previous study were recalled for follow-up and continued observation. The visual acuity, spherical equivalent, postoperative complications, non-contact intraocular pressure and subjective evaluation results were statistically analyzed preoperatively, at 1 to 2 days, 1 week, 1 month, 3 months, 6 months, 1 year and 5 years after operation. The main statistical methods included Mann Whitney U test, Wilcoxon signed rank test, independent sample t test, chi square test and Fisher exact test. Results: A total of 42 subjects (22 in the experimental group and 20 in the control group) completed 5-year continuous observation. Among the 42 subjects, 28 were female and 14 were male. The age was (70±9) years, and the time from surgery to recall was (5.77±0.19) years. The age, gender distribution, left/right eye distribution, axial length, IOL power and nucleus hardness classification data of the experimental group and the control group were balanced and comparable (all P>0.05). At different visiting time points, there was no significant difference in the best corrected distance visual acuity (BCDVA), best corrected near visual acuity (BCNVA), uncorrected distance visual acuity (UCDVA) and uncorrected near visual acuity (UCNVA) between the groups (all P>0.05). At 5 years after operation, the UCDVA, BCDVA and BCNVA of the two groups were significantly improved compared with the baseline [all P<0.01; UCDVA was improved from 0.75 (0.30 to 1.30) to 0.10 (-0.10 to 0.70) in the experimental group and from 0.75 (0.30 to 1.60) to 0.20 (-0.10 to 0.80) in the control group; BCDVA was from 0.60 (0.10 to 1.00) to 0.00 (-0.10 to 0.54) in the experimental group and from 0.60 (0.10 to 1.60) to 0.10 (-0.10 to 0.50) in the control group; BCNVA was from 0.55 (0.00 to 1.10) to 0.10 (-0.10 to 0.60) in the experimental group and from 0.55 (0.10 to 1.60) to 0.10 (-0.20 to 0.60) in the control group], but there was no significant change in the UCNVA (both P>0.05). There were no significant differences in the spherical equivalent, intraocular pressure, subjective evaluation of visual adverse symptoms, distance vision spectacle independence and comprehensive evaluation of satisfaction between the groups (all P>0.05). In the experimental group, one eye (4.5%) had an abnormal pupil, one eye (4.5%) had an abnormal IOL with a few particles on the surface of the IOL but no glistening, and 3 eyes (13.6%) had posterior capsular opacification (PCO); in the control group, one eye (5.0%) had an abnormal cornea, five eyes (25.0%) had abnormal IOLs [one eye (5.0%) had IOL calcification, and four eyes (20.0%) had IOL glistening], and one eye (5.0%) had PCO with posterior capsular folds and IOL tilt. There was no significant difference in PCO and IOL abnormality between the two groups (both P>0.05), but there was significant difference in the occurrence of IOL glistening (P=0.04). Conclusion: The long-term effect of A1-UV aspheric IOL on improving the UCDVA is stable and good, with high subjective satisfaction of patients, a low incidence of PCO, no glistening and good biocompatibility, over the postoperative 5 years. (Chin J Ophthalmol, 2021, 57: 41-47).

Intraocular lens calcification following phacotrabeculectomy in aniridic glaucoma

Intraocular lens calcification following phacotrabeculectomy in aniridic glaucoma

Opacification of an accommodative silicone intraocular lens in asteroid hyalosis

A case of opacification of an accommodating silicone intraocular lens (IOL) (Crystalens AO) in a patient with asteroid hyalosis (AH) is presented. A review the literature on dystrophic calcification of silicone IOLs and suggested management for improving visual symptoms in patients with this complication is discussed. Pathology of the explanted IOL of a 57-year-old man confirmed the presence of calcium. A review of the literature disclosed 37 other cases (eyes) of dystrophic calcification in the context of AH. Various IOL designs and manufacturers were reported. Of the 37 cases reported, none included an accommodating silicone IOL implant. To the authors′ knowledge, this is the first reported case of an accommodating silicone IOL to opacify in the presence of AH. Based on the literature review, silicone IOLs are at risk for opacification and should be avoided or used with extreme caution in patients with AH. In addition, YAG capsulotomy might hasten posterior IOL calcification, rendering IOL exchange more challenging.

Serial opacification of a hydrophilic-hydrophobic acrylic intraocular lens: analysis of potential risk factors.

To identify potential risk factors related to the opacification of a hydrophilic-hydrophobic acrylic intraocular lens (IOL) model. University Hospital Regensburg, Department of Ophthalmology, Regensburg, Germany. Cross-sectional study. All patients with a Lentis LS-502-1 IOL implanted at the Department of Ophthalmology were identified. Existing medical records and information from the treating ophthalmologists were reviewed to determine the IOL status (clear or opacified). Potential risk factors were analyzed using binary logistic regression models. A total of 223 IOLs of 199 patients were included. Sixty-seven (30.0%) opacified (calcified) IOLs were identified and compared with a control group of 156 IOLs. Statistical analyses revealed age at IOL implantation (odds ratio [OR] = 1.05, P = .012) to be associated with an increased risk of calcification. Posterior capsulotomy (OR = 0.45, P = .011) was found to have a protective influence. No other ophthalmic or systemic condition showed a significant association. Mean corrected distance visual acuity diminished significantly under opacification from 0.21 ± 0.25 logarithm of the correct minimum angle of resolution (logMAR) to 0.42 ± 0.32 logMAR (P < .001). IOL exchange in 55 of 67 cases at 45.8 ± 20.5 months after initial implantation yielded significant visual recovery (P = .001). Age at implantation might be a risk factor of IOL calcification, whereas posterior capsulotomy might be a protective factor. Calcification of the LS-502-1 IOL might be caused by the interaction of 3 main factors: IOL material traits, manufacturing-associated contamination, and patients' individual factors altering intraocular ion concentrations.

Variation in intraocular lens calcification under different environmental conditions in eyes with supplementary sulcus-supported lenses

PurposeAnalysis of explanted intraocular lenses (IOLs) from pseudophakic eyes with supplementary sulcus-supported IOLs. MethodsIn this laboratory investigation, ten supplementary and capsular bag IOLs were analyzed. All lenses were received between January 2012 and March 2018. Explants were examined morphologically with histological and electron microscopic techniques and patients’ medical history was evaluated. Additionally, we used a technique new to this field: Transmission Electron Microscopy and electron diffraction pattern analysis was performed to investigate the structure of the opacifying crystals in detail. ResultsEleven lenses were explanted due to IOL opacification from seven polypseudophakic eyes: In three cases the supplementary lens calcified, in three cases the capsular bag IOL (both lenses analyzed) and in one case both IOLs (only the supplementary was received). Additional surgical procedures and comorbidities included pars plana vitrectomy or Descemet stripping endothelial keratoplasty and diabetes mellitus. For each opacified lens, a varying layer of a Calcium phosphate beneath the optic surface was apparent. Crystal characterization revealed its composition to be Hydroxyapatite. Conclusions and ImportanceWe report on a series of secondary calcification in lenses explanted from polypseudophakic eyes. In some cases, calcification occurred in the capsular bag lens, in other cases in the supplementary lens, or in both. The severity of the morphological change could be related to the comorbidities and the presence of surgery subsequent to the lens implantations. Detailed morphology of the opacifying crystals was revealed.

Impact of Primary Calcification in Segmented Refractive Bifocal Intraocular Lenses on Optical Performance Including Straylight.

To describe and analyze the impact of calcification on the optical quality of segmented refractive bifocal intraocular lenses (IOLs). Eight segmented refractive bifocal IOLs made of hydrophilic acrylic were explanted from 8 patients due to opacification (and one opacified IOL that was not explanted) and analyzed in a cross-sectional study with laboratory analysis. Nine cases comprised three IOL models: LS-313 MF30 (5 cases), LS-312 MF30 (3 cases), and LS-313 MF15 (1 case). Material analysis with scanning and transmission electron microscopy confirmed IOL calcification. Measurements of modulation transfer function (MTF) and straylight permitted assessment of the IOL optical quality. Values were compared to a control lens. Except for one case of Nd:YAG (neodymium:yttrium-aluminum-garnet) capsulotomy, there was no secondary surgical procedure in the patients' histories. Eight of nine patients reported deteriorated visual quality, ultimately requiring IOL exchange. Material evaluation revealed fine granules of a calcium phosphate. Despite calcification, all but one lens still showed two distinct foci on the MTF measurements. Straylight values were higher than in a cataractous lens (33.1 deg2/sr) in all cases, with an average value of 170.1 ± 71.5 deg2/sr. Optical quality assessment showed that IOL calcification had a small effect on the MTF of segmented refractive bifocal lenses but a large impact on the straylight levels. Accordingly, in the clinical case, straylight levels were elevated. [J Refract Surg. 2020;36(1):20-27.].

Reasons for explantation, demographics, and material analysis of 200 intraocular lens explants.

To report demographics, reasons for explantation, and material changes in explanted intraocular lenses (IOLs). The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Germany. Retrospective study laboratory investigation. IOL explants that were sent consecutively to the laboratory were assessed for demographics (patient sex and age), duration of implant, IOL type, model, power, and reason for IOL explantation. In opacified lenses histological staining, scanning electron microscopy, and energy-dispersive X-ray spectroscopy was performed. The analysis included 200 IOLs that were explanted in median after 5.8 years. The median time the IOL was in the eye was 5.8 years. IOL opacification was the main cause for explantation in 153 (76.5%) cases. Only 27 (13.5%) were explanted due to dislocation. Evaluation of IOL type showed that 167 (83.5%) were made from hydrophilic acrylic material, with 125 (62%) from hydrophilic acrylic material with a hydrophobic surface coating. Analysis of opacities revealed superficial and subsurface deposits of calcium phosphate in most of the opacified lenses (152/153). In total, 22 different manufacturers were represented, with 119 (59.5%) lenses from a single manufacturer. In this cross-sectional study, late IOL calcification was the main reason for IOL explantation. The second most common reason was IOL dislocation. Most explants were lenses from a single manufacturer exchanged due to primary IOL calcification.

Calcification of hydrophilic acrylic intraocular lenses following secondary surgical procedures in the anterior and posterior segments

AimsTo report 15 cases of intraocular lens (IOL) calcification following intraocular surgery and to identify common risk factors.MethodsA retrospective case review of patients with IOL calcification reported from the Royal...

Opacification of hydrophilic intraocular lens after multiple injections of bevacizumab

In the literature various causes of opacification of hydrophilic lenses have been described. Pronounced opacity is a complication that must be taken seriously because it can lead to explantation or exchange of the intraocular lens (IOL). The calcification of hydrophilic IOLs is often made responsible for an explantation. Despite the rapidly increasing number of intravitreal injections, they have so far not been associated with opacification of lenses. This article reports on a female patient where opacification of the hydrophilic lens was obviously associated with multiple intravitreal injections over several years. It involved a secondary calcification with calcium phosphate deposition directly under the surface of the IOL. Possible pathomechanisms are discussed. Due to the increasing number of intravitreal injections the association with IOL opacity should be further evaluated in the future. Generally, with hydrophilic lens materials it must be taken into consideration that these can become opaque following diverse interventions.

Material Analysis and Optical Quality Assessment of Opacified Hydrophilic Acrylic Intraocular Lenses After Pars Plana Vitrectomy

Explanted hydrophilic intraocular lenses (IOLs) with clinically significant opacification after pars plana vitrectomy (PPV) were assessed for material change and optical quality, in an invitro laboratory study. Retrospective observational case series. Ten opacified IOLs after PPV with intraocular gas injection were analyzed in a laboratory setting. Analyses included evaluation of patients' medical history, optical quality assessment, light microscopy, histologic staining, scanning electron microscopy, and energy dispersive x-ray spectroscopy. In all 10 IOLs a thin layer of calcium phosphate that had accumulated underneath either the anterior or posterior optical surface in a central circular area of the IOL optic caused the opacification. The calcifications lead to deterioration of the modulation transfer function (MTF) across all spatial frequencies. PPV with instillation of gas into a pseudophakic eye with an acrylic hydrophilic lens seems to increase the risk for secondary calcification irrespective of the manufacturer. In these cases, IOL exchange is the only treatment option available. Since IOL exchange is associated with a high intraoperative complication rate, our results suggest to consider the risk of IOL calcification when implanting hydrophilic acrylic IOLs.

Topography, Wettability, and Electrostatic Charge Consist Major Surface Properties of Intraocular Lenses

ABSTRACTPurpose: To quantify potential relevant factors that affect the biocompatibility and functionality of intraocular lenses (IOLs) by analyzing the surface properties of various IOL materials.Methods: Eleven IOL models with the same dioptric power made by different manufacturers were studied. The IOLs were made of poly-methyl methacrylate (PMMA), hydrophobic acrylate, hydrophilic acrylate, and silicone. The IOL surface topography was evaluated using atomic force microscopy (AFM). Surface potential was measured by electric force microscopy (EFM). Surface wettability was assessed with the water contact angle using the sessile drop method.Results: The PMMA IOLs had statistically significant surface irregularities with the highest surface roughness values while the silicone and hydrophilic acrylic IOLs had the lowest values. Surface potentials on IOLs revealed that all IOL models made of PMMA had positive charge. The hydrophobic acrylic IOL had a significantly higher positive charge (6.2v ± 0.1v), while the hydrophobic acrylic with blue blocker exhibited negative charge. Negative charge was also observed on hydrophilic acrylic IOLs (–72mv ± 5mv) and silicone IOLs (–5.06v ± 0.02v). Contact angle values of PMMA IOLs ranged from 49° to 64°. Heparin modification resulted in significant reduction of the contact angle value. IOL models made of hydrophobic acrylate had contact angle values between 78° and 89°. The silicone IOL appeared to be significantly hydrophobic with the highest mean value of 107°.Conclusions: The variance of the parameters of surface roughness, contact angle, and electrostatic charge on the surfaces of PMMA, hydrophobic acrylic, hydrophilic acrylic, and silicone IOLs is useful to the interpretation of the differences in clinical behaviors of these materials. The negative surface charge of silicone and hydrophilic IOLs might account for the occurrence of IOL calcification.