Intraocular lens material evaluation by iris abrasion in vitro: a scanning electron microscope study

Prosthetic posterior chamber intraocular lenses can abrade the iris pigmented epithelium, resulting in pigment dispersion, callus formation, and iris adhesions. To evaluate iris abrasion from intraocular lens materials, we developed an in vitro test and studied three materials: polymethylmethacrylate (PMMA), silicone, and PMMA surface-modified by covalent binding of a hydrophilic polymer (surface-modified PMMA). Each lens was rubbed 1,000 times on the posterior iris of pigmented rabbits using a total force of 0.5 gram. Scanning electron micrographs of the abraded irides were scored using a subjective, nonparametric numerical scale. Polymethyl-methacrylate lenses removed iris epithelium completely, exposing underlying connective tissue. Silicone lenses damaged an area longer and narrower than the PMMA lens and also exposed connective tissue. Surface-modified PMMA lenses caused only slight surface damage, including flattening or breaking of protruding suspensory ligaments. The test conditions used cannot precisely mimic prolonged lens implantation in living subjects. Nevertheless, the results indicate that iris-lens interaction may be reduced in vivo by using a surface-modified PMMA lens. This hypothesis should be further verified by animal implantation studies.