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

To determine whether intraocular lens (IOL) material influences the membranous proliferation of lens epithelial cells (LECs) on the anterior surface of the IOL.

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

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.

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.

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.