Condensation on polymethylmethacrylate, acrylic polymer and silicone intraocular lenses after vitrectomy and fluid-air exchange

Purpose: Condensation on the posterior surface of intraocular lenses can markedly compromise the retinal view during vitrectomy and fluid-air exchange. In this study, we compared the condensation and subsequent retinal view degradation after vitrectomy and fluid-air exchange in rabbit eyes implanted with polymethylmethacrylate (PMMA), acrylic polymer and silicone IOLs. Methods: 30 rabbits underwent bilateral lens removal with phacoemulsification. 20 PMMA, 20 acrylic polymer and 20 silicone IOLs were implanted into the capsular bag. Following three port vitrectomy, eyes were randomly assigned to undergo a posterior capsulotomy or to an intact posterior capsule. Fluid-air exchange was performed. The posterior surface of the intraocular lens was then wiped with a soft-tipped cannula to remove the condensation. The amount of condensation on the IOL surface and resultant retinal view before and after wiping was graded intraoperatively by the surgeon, and by masked evaluation of intraoperative photographs. Results: No condensation occurred on IOLs in eyes with an intact posterior capsule. The amount of condensation on IOLs in eyes with an intact posterior capsule was significantly less than the condensation on IOLs in eyes with a capsulotomy, regardless of IOL type (p<0.014). Wiping the posterior IOL surface resulted in significantly less condensation and improved retinal view on the PMMA and acrylic IOLs when compared to the silicone IOLs (p<0.024). Conclusions: Condensation and subsequent retinal image degradation occurs uniformly following vitrectomy, posterior capsulotomy and fluid-air exchange in eyes with PMMA, acrylic and silicone IOLs. Because the condensation can be eliminated most easily on acrylic IOLs compared to silicone IOLs, when foldable IOL techniques are used it is likely that an acrylic polymer IOL would be advantageous for those patients at risk for future vitreous procedures requiring fluid-air exchange.

Duke Scholars

Author Glenn Jay Jaffe Ophthalmology, Vitreoretinal Diseases & Surgery