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. 2021 Mar;10(1):165-174.
doi: 10.1007/s40123-020-00329-8. Epub 2021 Feb 5.

Quantification of the In Vitro Predisposition to Glistening Formation in One Manufacturer's Acrylic Intraocular Lenses Made in Different Decades

Qiang Wang  1   2 , Timur M Yildirim  1 , Sonja K Schickhardt  1 , Grzegorz Łabuz  1 , Ramin Khoramnia  1 , Patrick R Merz  1 , Hyeck-Soo Son  1 , Donald J Munro  1 , Elfriede Friedmann  1   3 , Gerd U Auffarth  4
Affiliations

Quantification of the In Vitro Predisposition to Glistening Formation in One Manufacturer's Acrylic Intraocular Lenses Made in Different Decades

Qiang Wang et al. Ophthalmol Ther. 2021 Mar.

Abstract

Introduction: Foldable hydrophobic acrylic intraocular lenses (IOLs) are prone to develop a long-term postoperative material change called glistenings. The aim of this study was to investigate the changes in the predisposition for glistening formation in one type of hydrophobic acrylic IOL material from its introduction to the present day.

Methods: In a laboratory setup, an in vitro model was used to induce glistenings in hydrophobic acrylic IOLs manufactured by one company (Alcon, Fort Worth, TX, USA) in different years: 23 1990s-manufacture hydrophobic acrylic three-piece IOLs (MA30BA/MA60AC) that were explanted in 1996 and 1997, and five of each of the newer AcrySof IOL models (MA60AC, SA60AT, TFNT00 and SN60WF) from 2014 to 2017. Furthermore, five Clareon (SY60WF) IOLs were put through the same accelerated aging procedure. The number of microvacuoles per square millimeter (MV/mm2) was determined in the central part of each IOL optic and compared between the groups.

Results: The mean number of MV was highest in the 1990s-manufacture Alcon acrylic IOLs, with 1289 (± 738) MV/mm2. The number decreased to 650 (± 101), 192 (± 105), 175 (± 112) and 47 (± 26) for MA60AC, SA60AT, TFNT00 and SN60WF, respectively. The lowest count was obtained in the Clareon group, with 1 (± 1) MV/mm2.

Conclusions: A high number of glistenings was induced in the explanted IOLs from the 1990s. The propensity for glistening formation decreased considerably after that decade and now in current use. Even though in vitro glistening formation in today's AcrySof material was low, the Clareon material was essentially glistenings-free.

Keywords: Accelerated aging; Biomaterial stability; Glistenings; IOL material history; IOL pathology.

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Figures

Fig. 1
Fig. 1
Overview images of different AcrySof intraocular lenses (IOLs) after the same in vitro glistening induction procedure in 14-fold magnification. The three-piece AcrySof IOL upper left was explanted in 1996 and developed a large number of microvacuoles, giving the whole optic a whitish appearance. The AcrySof IOLs from later years show a decreasing number of microvacuoles
Fig. 2
Fig. 2
Number of microvacuoles induced in vitro in each intraocular lens (IOL) group from different years and production lines. The mean glistening number and range was highest in the explanted AcrySof IOLs from the 1990s. The number was decreased in AcrySof IOLs from subsequent years. Using the same accelerated aging procedure, almost no microvacuoles could be induced in lenses from Clareon material
See this image and copyright information in PMC

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