Purpose: To assess the clinical biocompatibility of AcrySof (Alcon, Ft Worth, Tex) acrylic intraocular lenses (IOLs) in the highly reactive eyes of infants and children.
Methods: A database of 230 pediatric IOL implantations was queried to allow retrospective review of all eyes implanted with an AcrySof IOL. Eyes implanted with polymethyl methacrylate (PMMA) IOLs were also reviewed and were used as a historical comparison group. Follow-up examinations were conducted by the surgeon on postoperative day 1, day 7, week 4, and week 8 and every 3 months during the first year and every 6 months thereafter. The presence of synechiae, lens deposits, and posterior capsule opacification were noted in the record at each visit. Examination notes were photocopied, and data were extracted from each visit note and entered into a computerized database.
Results: One hundred and ten eyes had an AcrySof IOL at an average age of 60.4 months and had an average postoperative follow-up of 64.6 weeks. In comparison, 120 eyes had PMMA IOLs inserted at an average age of 71.9 months with an average postoperative follow-up of 136.9 weeks. IOL cell deposits were seen at the slit lamp in 7 of 110 (6.4%) AcrySof lenses as compared with 26 of 120 (21.75%) PMMA lenses (P =.002). Posterior synechiae were seen in 5 of 110 (4.5%) AcrySof lenses as compared with 23 of 120 (19.2%) PMMA lenses (P =.001). Twenty-two AcrySof-implanted eyes had an intact posterior capsule. Twenty-eight PMMA-implanted eyes had an intact posterior capsule. The YAG laser capsulotomy rate was similar in the 2 groups at 45.4% for AcrySof and 50% for PMMA (P =.973). The average time from surgery to YAG posterior capsulotomy was 18.6 months with an AcrySof lens and 18.3 months with a PMMA lens (P =.951; t test). A total of 60 patients (68%) implanted with AcrySof IOLs were able to cooperate for Snellen visual acuities. Of their 67 eyes, 48 (72%) had a 20/40 or better visual acuity at the last follow-up examination, and 63 eyes (94%) had a 20/100 or better visual acuity. Thirty-five eyes (52%) required amblyopia therapy, and patching continues as needed.
Conclusions: The AcrySof IOL is representative of a new group of foldable IOLs made from flexible hydrophobic acrylic material. The AcrySof IOL appears clinically to be biocompatible when placed in the eyes of children despite the increased tissue reactivity known to occur in young patients.