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Review
. 2025 Jan 1;36(1):18-24.
doi: 10.1097/ICU.0000000000001095. Epub 2024 Oct 23.

How do intraocular lens materials influence the outcome of cataract surgery?

Andrzej Grzybowski  1   2 , Gerd U Auffarth  3 , Benjamin R LaHood  4   5   6   7
Affiliations
Review

How do intraocular lens materials influence the outcome of cataract surgery?

Andrzej Grzybowski et al. Curr Opin Ophthalmol. .

Abstract

Purpose of review: This review summarizes the evidence on the effect of intraocular lens (IOL) material on the outcomes of cataract surgery, as well as on the surgical procedure itself.

Recent findings: Differences in capsular biocompatibility between IOL materials lead to variations in capsular stability and posterior capsule opacification (PCO), while differences in uveal biocompatibility affect postoperative inflammatory response.

Summary: Refractive outcomes are affected by both incision size and the rotational stability of toric IOLs. Small incision sizes favour hydrophilic IOLs. Rotational stability of hydrophobic and hydrophilic IOLs were comparable in recent studies. Visual outcomes are affected by chromatic aberrations, dysphotopsia, lens opacifications and PCO. Hydrophilic IOLs are associated with reduced chromatic dispersion. Hydrophobic IOL opacifications are caused by sub-surface glistenings, while hydrophilic IOL opacifications are due to surface calcifications. Some surgeries, including pars plana vitrectomy and lamellar corneal transplants, were shown to increase the risk of IOL calcifications, although the mechanism is still unknown. Hydrophilic IOLs have greater ease of manipulation, greater resistance to IOL damage, and higher uveal biocompatibility. Hydrophobic IOLs show better PCO prevention than hydrophilic IOLs, and should be preferred in highly myopic eyes where Nd:YAG capsulotomy might increase the risk of retinal detachment.

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Conflict of interest statement

Andrzej Grzybowski reports grants personal fees, nonfinancial support and consulting fees from Alcon, Bausch&Lomb, Zeiss, Teleon, J&J, CooperVision, Hoya, Essilor, Thea, Polpharma, Viatris, Alcon, Polpharma, Viatris, Eyerising, Rayner. He is Member of Advisory Boards: Nevakar, Santen, Eyerising, GoCheckKids and Thea.

Gerd U Auffarth reports grants, personal fees, nonfinancial support and consulting fees from Johnson & Johnson and Alcon, grants, personal fees, and nonfinancial support from Carl Zeiss Meditec, Hoya, Kowa, Oculentis/Teleon, Rayner, Santen, Sifi, Ursa-pharm, grants and personal fees from Biotech, Oculus, EyeYon grants from Acufocus, Contamac, Glaukos, Physiol and Rheacell, outside the submitted work.

Ben LaHood is a consultant to Alcon and has received honoraria from Zeiss, Bausch&Lomb, BVI, Rayner, and Hoya.

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