The effect of three different acrylic intraocular lenses on the glistening formation

Dušan  Todorović; Sunčica Srećković; Nenad Petrović; Mirko Resan; Goran Damjanović; Željko Todorović; Tatjana Šarenac Vulović

doi:10.2298/VSP231208087T

Dušan Todorović University Clinical Center Kragujevac, *Clinic for Ophthalmology, Kragujevac, Serbia
Sunčica Srećković University Clinical Center Kragujevac, *Clinic for Ophthalmology, Kragujevac, Serbia
Nenad Petrović University Clinical Center Kragujevac, *Clinic for Ophthalmology, Kragujevac, Serbia
Mirko Resan ‡University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbi
Goran Damjanović University Clinical Center of Serbia, University Eye Clinic, Belgrade, Serbia
Željko Todorović University Clinical Center Kragujevac, Clinic for Hematology, Kragujevac, Serbia
Tatjana Šarenac Vulović University Clinical Center Kragujevac, *Clinic for Ophthalmology, Kragujevac, Serbia

DOI: https://doi.org/10.2298/VSP231208087T

Keywords: cataract;, lenses, intraocular;, ophthalmologic surgical procedures;, phacoemulsification.

Abstract

Background/Aim. One of the postoperative complications of phacoemulsification is the formation of fluid-filled microvacuoles inside the implanted intraocular lens (IOL). This condition is known as ‘glistening’. The aim of this study was to determine the incidence of glistening formation after the implantation of three different acrylic IOLs during the two-year follow-up period. Methods. Cataract surgery was performed in 93 patients (93 eyes) with developed senile cataracts. According to the implanted IOL, patients were equally divided into three groups: group with single-piece hydrophilic (SPHphil) acrylic IOL, group with single-piece hydrophobic (SPHphob) acrylic IOL, and group with three-piece hydrophobic (TPHphob) acrylic IOL. The presence of glistening was measured five times: 1, 6, 12, 18, and 24 months after phacoemulsification. Results. Statistically significantly lower glistening incidence was recorded in the SPHphil group compared to the SPHphob and TPHphob group, six months after phacoemulsification (p < 0.05). That difference was even higher one year after the cataract surgery (p < 0.01) and remained at that level until the end of the study. During the whole follow-up period, no statistically significant difference was recorded among SPHphob and TPHphob groups (p > 0.05). Conclusion. The presence of glistening was recorded in all groups. Our results strongly suggest that the progression of glistening was the most pronounced in the first postoperative year. However, a very low glistening incidence associated with SPHphil IOL could be particularly beneficial in patients expected to develop increased postoperative inflammation.

References

Villegas EA, Manzanera S, Lago CM, Hervella L, Sawides L, Ar-tal P. Effect of Crystalline Lens Aberrations on Adaptive Op-tics Simulation of Intraocular Lenses. J Refract Surg 2019; 35(2): 126–31.

Narayan A, Evans JR, O'Brart D, Bunce C, Gore DM, Day AC. Laser-assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery. Cochrane Database Syst Rev 2023; 6(6): CD010735.

Fernández-Muñoz E, Chávez-Romero Y, Rivero-Gómez R, Aridjis R, Gonzalez-Salinas R. Cumulative Dissipated Energy (CDE) in Three Phaco-Fragmentation Techniques for Dense Cataract Removal. Clin Ophthalmol 2023; 17: 2405–12.

Pirogova ES, Fabrikantov OL, Nikolashin SI. Femtolaser-assisted phacoemulsification of intumescent cataract. Vestn Oftalmol 2022; 138(1): 13–22. (Russian)

Hu J, Zhao C, Luo Y, Kong J, Shi W, Wang T. Real-time corneal thickness changes during phacoemulsification cataract surgery. Graefes Arch Clin Exp Ophthalmol 2023; 261(6): 1609–18.

Coppola M, Marchese A, Rabiolo A, Cicinelli MV, Knutsson KA. Comparison of two popular nuclear disassembly techniques for cataract surgeons in training: divide and conquer versus stop and chop. Int Ophthalmol 2019; 39(9): 2097–102.

Nikose AS, Saha D, Laddha PM, Patil M. Surgically induced astigmatism after phacoemulsification by temporal clear cor-neal and superior clear corneal approach: a comparison. Clin Ophthalmol 2018; 12: 65–70.

Tripathy K, Sridhar U. Optical coherence tomography of intra-ocular lens glistening. Indian J Ophthalmol 2019; 67(1): 138–9.

Chassain C, Chamard C. Posterior capsule opacification, glis-tenings and visual outcomes: 3 years after implantation of a new hydrophobic IOL. J Fr Ophtalmol 2018; 41(6): 513–20. (French)

Fernández-Vigo JI, Macarro-Merino A, De Moura-Ramos JJ, Alva-rez-Rodriguez L, Burgos-Blasco B, Novo-Bujan J, et al. Compara-tive study of the glistening between four intraocular lens mod-els assessed by OCT and deep learning. J Cataract Refract Surg 2024; 50(1): 37–42.

Yildirim TM, Schickhardt SK, Wang Q, Friedmann E, Khoramnia R, Auffarth GU. Quantitative evaluation of microvacuole formation in five intraocular lens models made of different hydrophobic materials. PLoS One 2021; 16(4): e0250860.

Fernández-Vigo JI, Serrano González-Peramato MT, Nunila Gómez-de-Liaño C, Sánchez-Guillén I, Fernández-Vigo JÁ, Macarro-Merino A. Glistening on intraocular lenses: A review. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98(9): 493–506.

Wang Q, Yildirim T, Schickhardt SK, Łabuz G, Khoramnia R, Merz PR, et al. Quantification of the In Vitro Predisposition to Glistening Formation in One Manufacturer’s Acrylic Intra-ocular Lenses Made in Different Decades. Ophthalmol Ther 2021; 10(1): 165–74.

Gupta PC, Balamurugan R, Ram J. Multimodal imaging of glis-tening IOL. Saudi J Ophthalmol 2018; 32(4): 358–9.

Xiang Y, Jin R, Zhang Y, Li K, Liu G, Song X, et al. Foldable Glistening-Free Acrylic Intraocular Lens Biomaterials with Dual-Side Heterogeneous Surface Modification for Postopera-tive Endophthalmitis and Posterior Capsule Opacification Prophylaxis. Biomacromolecules 2021; 22(8): 3510–21.

Kawai K. An evaluation of glistening and stability of intraocu-lar lens material manufactured by different methods. Eur J Ophthalmol 2021; 31(2): 427–35.

Auffarth GU, Brézin A, Lignereux F, Khoramnia R, Yildirim TM, Kohnen T, et al. Randomized multicenter trial to assess posteri-or capsule opacification and glistenings in two hydrophobic acrylic intraocular lenses. Sci Rep 2023; 13(1): 2822.

Argay A, Vamosi P. The assessment of the impact of glistening on visual performance in relation to tear film quality. PLoS One 2020; 15(10): e0240440.

Miyata A, Uchida N, Nakajima К, Yaguchi S. Clinical and exper-imental observation of glistening in acrylic intraocular lenses. Jpn J Ophthalmol 2001; 45(6): 564–69.

Ortega-Prades G, Hervás Hernándis JM, Duch-Samper AM. Glis-tening on intraocular lens. Anterior segment optic coherence tomography image. Arch Soc Esp Oftalmol (Engl Ed) 2024; 99(6): 269.

Bhattacharjee H, Bhattacharjee K, Das D, Javeri H, Buragohain S. Raman Spectroscopy of six explanted acrylic hydrophobic foldable intraocular lenses with glistening. Indian J Ophthal-mol 2022; 70(8): 2872–6.

Kanclerz P, Grzybowski A. Glistenings might be associated with disability glare. Eur J Ophthalmol 2022; 32(1): NP296.

Kato K, Nishida М, Yamane H, Nakamae K, Tagami Y, Tetsumoto K. Glistening formation in an AcrySof lens initiated by spi-nodal decomposition of the polymer network by temperature change. J Cataract Refract Surg 2001; 27(9): 1493–8.

Błachnio K, Dusińska A, Szymonik J, Juzwiszyn J, Bestecka M, Chabowski M. Quality of Life after Cataract Surgery. J Clin Med 2024; 13(17): 5209.

Grzybowski A, Markeviciute A, Zemaitiene R. A narrative review of intraocular lens opacifications: update 2020. Ann Transl Med 2020; 8(22): 1547.

Tandogan T, Auffarth GU, Son HS, Merz P, Choi CY, Khoramnia R. In-vitro glistening formation in six different foldable hy-drophobic intraocular lenses. BMC Ophthalmol 2021; 21(1): 126.

Mao Y, Liu H, Long Gu F, Wu MX, Wang Y. The molecular design of performance-enhanced intraocular lens composites. Biomater Sci 2022; 10(6): 1515–22.

Stanojcic N, Hull CC, Mangieri E, Little N, O'Brart D. A new software for automated counting of glistenings in intraocular lenses in vivo. Int J Ophthalmol 2023; 16(8): 1237–42.

Yildirim TM, Fang H, Schickhardt SK, Wang Q, Merz PR, Auffarth GU. Glistening formation in a new hydrophobic acrylic intraocular lens. BMC Ophthalmol 2020; 20: 186.

Borghesi S, Colciago S, Zeri F, Scialdone A, Tavazzi S. In vitro glistening formation in IOLs: automated method for assessing the volumetric density and depth distribution of microvacu-oles. J Cataract Refract Surg 2020; 46(8): 1178–83.

Khoramnia R, Yildirim TM, Łabuz G, Mayer CS, Auffarth GU. Opacification of intraocular lenses: laboratory and clinical findings. Ophthalmologe 2021; 118(7): 633–42. (German)

Colin J, Praud D, Touboul D, Schweitzer C. Incidence of glisten-ings with the latest generation of yellow-tinted hydrophobic acrylic intraocular lenses. J Cataract Refract Surg 2012; 38(7): 1140–6.

Ton Van C, Tran THC. Incidence of posterior capsular opaci-fication requiring Nd:YAG capsulotomy after cataract surgery and implantation of enVista® MX60 IOL. J Fr Ophtalmol 2018; 41(10): 899–903.

Rønbeck М, Behndig А, Taube М, Koivula А, Kugelberg М. Com-parison of glistenings in intraocular lenses with three different materials: 12-year follow-up. Acta Ophthalmol 2013; 91(1): 66–70.

Omar O, Pirayesh A, Mamalis N, Olson RJ. In vitro analysis of AcrySof intraocular lens glistenings in AcryPak and Wagon Wheel packaging. J Cataract Refract Surg 1998; 24(1): 107–13.

Łabuz G, Knebel D, Auffarth GU, Fang H, van den Berg TJ, Yild-irim TM, et al. Glistening Formation and Light Scattering in Six Hydrophobic-Acrylic Intraocular Lenses. Am J Ophthal-mol 2018; 196: 112–20.

Wilkins E, Olson RJ. Glistenings with long-term follow-up of the Surgidev B20/20 polymethylmethacrylate intraocular lens. Am J Ophthalmol 2001; 132(5): 783–5.

Schweitzer C, Orignac I, Praud D, Chatoux O, Colin J. Glistening in glaucomatous eyes: visual performances and risk factors. Acta Ophthalmol 2014; 92(6): 529–34.

Colin J, Orignac I. Glistenings on intraocular lenses in healthy eyes: effects and association. J Refract Surg 2011; 27(12): 869–75.

Khoramnia R, Naujokaitis T, Baur ID, Hassel O, Henningsen N, Reitemeyer E, et al. Functional Outcomes After Refractive Lens Exchange With Implantation of a Glistening-Free Dif-fractive Trifocal Intraocular Lens. Am J Ophthalmol 2024; 268: 296–305.

Packer M, Williams JI, Feinerman G, Hope RS. Prospective mul-ticenter clinical trial to evaluate the safety and effectiveness of a new glistening-free one-piece acrylic toric intraocular lens. Clin Ophthalmol 2018; 12: 1031–9.