Exfoliation syndrome and heparin surface modified intraocular lenses

Either heparin surface modified (HSM) or regular polymethyl methacrylate (PMMA) intraocular lenses (IOLs) were implanted after extracapsular cataract extraction in 40 human eyes with exfoliation syndrome in a double-masked, randomized study. The patients were investigated preoperatively, and then 1 day, 1 week, 3, 6 and 12 months postoperatively. In eyes implanted with the HSM IOL, 26% had a fibrinoid reaction anterior to the IOL, while this complication was found in 50% of eyes implanted with the regular IOL. Pigment and cell deposits were more frequent on the regular IOLs than on the HSM lenses postoperatively. Posterior synechia formation between the iris and the implant or lens capsule was more common in the eyes with regular IOL compared to HSM IOL. No difference in visual acuity between the two groups was found either before or after surgery. The results suggest that in eyes with exfoliation syndrome, a heparin surface modified IOL reduces clinical complications associated with cataract surgery.