In vivo study of cell reactions on poly(methyl methacrylate) intraocular lenses with different surface properties

Purpose: To evaluate the biocompatibility of three poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) with different surface properties. Setting: University Eye Clinic, Vienna, Austria. Methods: Cell reactions on the surfaces of unmodified, heparin-surface-modified (HSM), and surface-passivated (SP) PMMA IOLs were documented in vivo using a Zeiss specular microscope. Risk factors for such reactions were also determined. Results: During the first postoperative days, small round and spindle-shaped cells were found on all IOLs. Cell density was higher in eyes with increased postoperative inflammation. After several days, epithelioid and foreign-body giant cells were seen on some IOLs. Cells appeared significantly less often on the IOLs with hydrophilic surfaces (HSM) than on those with hydrophobic surfaces (unmodified, SP). Conclusion: The significantly lower incidence of foreign-body reactions on hydrophilic than on hydrophobic IOL surfaces is consistent with the results of previous studies on hydrogel and silicone IOLs.