Hydrophobic acrylic and plate-haptic silicone intraocular lens implantation in diabetic patients: pilot randomized clinical trial.
OBJECTIVE
To compare the capsular and uveal reaction after implantation of a plate-haptic silicone intraocular lens (IOL) (C11UB, Chiron) and a hydrophobic acrylic (AcrySof MA60, Alcon) IOL in diabetic patients.


METHODS
Moorfields Eye Hospital and St. Thomas' Hospital, London, United Kingdom.


METHODS
Thirty-five diabetic patients were recruited consecutively and randomly assigned to have implantation of either of the 2 IOLs. The percentage area of posterior capsule opacification (PCO), anterior capsule contraction (ACC), and postoperative inflammatory indices (flare and cells) were assessed objectively at 2 to 3 weeks, 6 months, and 1 year. Between-group and within-group analyses were conducted using the Student t test or Mann-Whitney test and Friedmann test, respectively.


RESULTS
Between-group analysis showed the percentage area of PCO was significantly greater in patients with plate-haptic silicone IOLs at 6 and 12 months (P = .002). At 6 months, ACC was significantly greater in the plate-haptic group (P = .04), but the difference was not significant at 12 months. There was higher flare in the hydrophobic acrylic IOL group than in the plate-haptic silicone IOL group at 2 to 3 weeks (P = .08). Within-group analysis showed that over the follow-up period, the plate-haptic silicone group, but not the hydrophobic acrylic group, had a progressive increase in PCO (P = .003). In the hydrophobic acrylic group, but not the plate-haptic silicone group, there was a significant reduction in the mean anterior chamber flare value (P = .01). There was no significant difference in visual acuity or contrast sensitivity at any postoperative visit.


CONCLUSIONS
In diabetic patients, hydrophobic acrylic IOLs can lead to an increased flare in the early postoperative period but they seem to be more favorable than plate-haptic silicone IOLs because the latter lead to more PCO.
Elgohary
Mostafa A
MA
Moorfields Eye Hospital, London, United Kingdom. m.elgohary@doctors.org.uk
Hollick
Emma J
EJ
Bender
Lloyd E
LE
Heatley
Catherine J
CJ
Wren
Siobhan M
SM
Boyce
James
J
Missotten
Tom
T
Spalton
David J
DJ
Dowler
J G
JG
D000180:Acrylic Resins; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D005549:Foreign-Body Reaction / Q000175:diagnosis; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D007903:Lens Capsule, Crystalline / Q000473:pathology; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D010865:Pilot Projects; D011183:Postoperative Complications; D012826:Silicone Elastomers
D000180:Acrylic Resins; D001672:Biocompatible Materials; D012826:Silicone Elastomers