BELGRADE, Serbia — Due to the relatively high rates of posterior capsule opacification reported with hydrophilic acrylic IOLs, companies are gradually converting to hydrophobic IOLs.
“This is an impression of many of us through many years that hydrophobic as a material has certainly much less PCO. It does not matter whether you put a sharp edge on a hydrophilic, it is never going to be as good as a sharp edge on a hydrophobic. The disadvantage of hydrophobic IOLs is that they are more likely to cause negative dysphotopsia, but that can probably be overcome,” Richard Packard, MD, said in an interview with Healio.com/OSN at the European Society of Cataract and Refractive Surgeons winter meeting.
Oculentis voluntarily recalled several models of the Lentis IOL family due to notifications of sporadic late postoperative opacification, and the company carried out a study to investigate potential causes. Analysis suggested that the problem might be due to phosphate remnants from a detergent used in the manufacturing process.
“The problem seems to be solved for this group of lenses, but the company is now moving away from hydrophilic and is going to launch the new hydrophobic IOLs later this year,” Packard said.
Multiple factors can cause opacification. Opacification has largely been reported with hydrophilic lenses in patients with glaucoma and diabetes and after endothelial transplantation. Ophthalmic viscosurgical devices containing phosphates are also under scrutiny, but studies have so far been inconclusive. The studies carried out by Oculentis found that quite a lot of patients implanted binocularly with their IOLs had opacification only in one eye, which confirms that several factors, mostly unknown, are involved.
“What recent research seems to indicate is that every hydrophilic lens should ultimately opacify. I suspect that conversion to hydrophobic will happen quite fast and that we will see hydrophilic lenses gradually disappear within the next 5 years,” Packard said. – by Michela Cimberle
Disclosure: Packard reports he received fees for participating in the Oculentis study.