Tissue reaction to hydrophilic intraocular lenses

The implant of intraocular lenses (IOLs) following cataract surgery induces a foreign body reaction to the IOL and a lens epithelial cell reaction. The host response to the IOL is mainly influenced by biomaterial properties. With the increasing use of phacoemulsification and small incision cataract surgery, there is growing interest in the use of foldable IOLs made of different materials. Hydrophilic acrylic IOLs include a wide group of foldable biomaterials different in terms of water content. These lenses have been reported to show a good biocompatibility after implantation. Nevertheless, tissue reaction to the implant of hydrophilic lenses is variable and not directly related to the hydrophilicity of their surface. A different adsorption of proteins on the IOL optic surface might be responsible for the different cellular reaction and lens epithelial cell response. Other properties besides hydrophilicity should be taken into account to classify IOL biomaterials.