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C. Heinz, M. Roesel, A. Heiligenhaus; Uveal and Capsular Biocompatibility of Two Acrylic Intraocular Lenses in Patients With Non-infectious Uveitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3915.
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Cataract formation is a common complication in uveitis patients. In this study, a hydrophobic and a hydrophilic acrylic intraocular lens (IOL) were compared with respect to uveal and capsular biocompatibility, visual outcome and postoperative complications.
Prospective, randomized study with 56 patients (62 eyes) with inactive non-infectious uveitis, who underwent phacoemulsification with IOL implantation. Patients either received an AcrySof TM (group 1) or an Akreos adapt TM (group 2) IOL. Follow-up was scheduled at 1, 3 and 6 months postoperatively. At each time point, best-corrected visual acuity (BCVA), anterior (ACO) and posterior capsule opacification (PCO) laser-flare photometry (Kowa FC 100, Japan), anterior chamber cells, and posterior synechiae were determined.
While 29 eyes (aged 52.9±17.4 yrs) received an AcrySofTM IOL, another 33 got an Akreos AdaptTM IOL (47.9±20.1 yrs). The groups did not differ with respect to anatomic type of uveitis, immunosuppression, associated systemic disease, and intraoperative manipulation (e.g., synechiolysis, membrane removal, sphincterotomy). BCVA at 6 month increased in the group 1 from 0.824 logMAR to 0.352, and in group 2 from 0.739 to 0.238 (p=0.237). The numbers of anterior chamber cells did not differ between the groups at any time-point after surgery. Laser-flare photometry levels after 1 month were higher in the group 1 than in the group 2 (means, 42.4 vs. 25.8 photons/s; p=0.063), and a slight difference was still found after 6 month (means, 9.6 vs. 5.3; p=0.199). The numbers of cell deposits on the anterior IOL surface in the group 1 were slightly higher than in the group 2 (p=0.181). The ACO rates did not differ between the groups (p=0.41). The PCO rates and the numbers of Nd:YAG laser capsulotomies (p=0.140) were higher in the group 2 than in the group 1. At 6 months postoperatively, posterior synechiae were noted in one patient in the group 1, and in none patient in the group 2 (p=0.547).
This study shows that both of the acrylic IOLs used had good capsular and uveal biocompatibility, leading to significant improvement of BCVA patients with no-infectious uveitis. While the uveal biocompatibility was better with hydrophilic acrylic IOL, the PCO rate was better with hydrophobic acrylic IOL.
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