Evaluation of giant-cell deposits on foldable intraocular lenses after combined cataract and glaucoma surgery.
OBJECTIVE
To compare the incidence of inflammatory giant-cell deposits (IGCDs) on various foldable intraocular lenses (IOLs) after combined cataract and glaucoma surgery.


METHODS
The Phillips Eye Institute, Minneapolis, Minnesota, USA.


METHODS
In this prospective randomized clinical trial, 128 patients were randomized to receive a single-piece, first-generation silicone lens (n = 36); a 3-piece acrylic lens (n = 40); or 3-piece, second-generation silicone lens (n = 52). All patients had combined phacoemulsification and trabeculectomy with mitomycin-C by 1 surgeon using a standardized technique. Dilated biomicroscopy was used to identify and quantitate IGCDs on the surface of the IOLs using a 6-point grading scale.


RESULTS
Inflammatory giant-cell deposits were identified on 21 of 128 IOLs. Lens design was the most significant risk factor for deposit formation (P =.004). Inflammatory giant-cell deposits were most common in the first-generation silicone plate lens group (33%), less common in the acrylic lens group (15%), and least common in the 3-piece, second-generation silicone group (5.8%). Density of the deposits was significantly greater on the plate lens than the acrylic or the 3-piece silicone lenses (P <.0001). Although IOL design was the most significant risk factor for IGCD formation, other significant risk factors included intraoperative pupil stretch (P =.02) and preoperative miotic use (P =.04).


CONCLUSIONS
Inflammatory giant-cell deposit formation was significantly greater on first-generation silicone plate IOLs than on acrylic or second-generation silicone IOLs. The deposits were somewhat more common on acrylic IOLs than on second-generation silicone IOLs. However, this difference was not clinically or statistically significant.
Samuelson
T W
TW
The Phillips Eye Institute, Minneapolis, Minnesota 55404-3810, USA.
Chu
Y R
YR
Kreiger
R A
RA
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002386:Cataract / Q000150:complications*; D002448:Cell Adhesion; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D015743:Giant Cells, Foreign-Body / Q000473:pathology*; D005901:Glaucoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D007910:Lenses, Intraocular / Q000009:adverse effects*; D009883:Ophthalmic Solutions; D018918:Phacoemulsification / Q000009:adverse effects*; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D011446:Prospective Studies; D011475:Prosthesis Failure; D012008:Recurrence; D012086:Reoperation; D012826:Silicone Elastomers / Q000009:adverse effects; D013499:Surface Properties; D014130:Trabeculectomy / Q000009:adverse effects*
D000893:Anti-Inflammatory Agents; D009883:Ophthalmic Solutions; D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate