Glistenings common with certain foldable IOLs, inconsequential

Chicago-Glistenings are common in the hydrophobic acrylic material of certain foldable IOLs (AcrySof, Alcon Laboratories), but they are not visually significant, said Joseph Colin, MD, at the annual meeting of the American Academy of Ophthalmology.

"Our research evaluating the impact of glistenings in AcrySof IOLs implanted in normal eyes and eyes of [patients with] glaucoma indicates their presence does not adversely affect visual acuity, contrast sensitivity, higher-order aberrations, or light scattering," he said. "These findings are consistent with the fact that AcrySof IOL explantation due to the presence of glistenings has only been rarely reported in the literature. In fact, there is just a single case."

Incidence, severity

To investigate the incidence and severity of glistenings associated with AcrySof IOLs, Dr. Colin and colleagues undertook a prospective study including 260 eyes followed for more than 6 months post-implantation. Glistenings in each IOL were digitally analyzed in slit lamp photographs using a computerized system and graded on a severity scale of 0 to 2 based on total area.

Among the 260 eyes, the glistenings were considered grade 0 (area 0 to 500 mm²) in about 40% of eyes, grade 1 (50 to 150 mm²) in 33.5%, and grade 2 (>150 mm²) in about 27% of eyes.

Further analyses explored possible associations between the presence of glistenings and various clinical and demographic factors and showed statistically significant associations with glaucoma, depression, and IOL power. Patient age, gender, IOL model, length of follow-up, use of systemic medications, or other ocular and systemic diseases were not found to predict the presence of glistenings.

"The association with depression may be related to glaucoma," Dr. Colin said.

The clinical effect of AcrySof IOL glistenings on quality of vision was evaluated in two study populations, one including 99 normal eyes and another including 67 eyes of patients with glaucoma. The assessments, which were performed at 3 months post-implantation, included best-corrected visual acuity, posterior capsule opacification (EPCO software), contrast sensitivity (Vector Vision), and light scattering (C-QUANT).

With eyes divided based on glistening grade, there were no statistically significant differences between the subgroups in any of the endpoints in either normal eyes or eyes of patients with glaucoma.

FYI

Joseph Colin, MDE-mail: joseph.colin@chu-bordeaux.fr

Dr. Colin is a consultant to Alcon Laboratories.