Complement activation by nylon- and polypropylene-looped prosthetic intraocular lenses

Uncomplicated placement of an intraocular lens at the time of routine cataract extraction is associated with a greater inflammatory response than simple lens extraction. We have shown that certain components of prosthetic intraocular lenses are capable of activating the complement system in human serum in such a fashion as to generate peptides capable of mediating acute inflammatory reactions. Normal human serum was incubated with intraocular lenses in vitro and then examined for cleavage products of C3 and C5 and for C5-derived chemotactic activity for human polymorphonuclear leukocytes. Polymethylmethacrylate lenses with nylon and polypropylene loops were found to be capable of causing cleavage of C3 (detected by crossed immunoelectrophoresis) and C5 (detected by single-dimension radioimmunoelectrophoresis) as well as generation of C5-derived chemotactic activity in human serum. Serum incubated with polymethylmethacrylate lenses without loop supports exhibited no such activity. Results of our studies indicate that certain nylon- and polypropylene-looped intraocular lenses are not "inert" biologically and may elicit acute inflammatory reactions.