Clinical results with soft intraocular lenses of poly-HEMA

In a prospective study 28 patients were unilaterally implanted with a flexible posterior chamber lens made of poly-HEMA. Clinical results of 18 months follow up is reported. Implantation of the one-piece lens was more difficult in some patients according to the elastic property of the lens in comparison to PMMA-lenses. This is expressed in 8 patients in which a asymmetric sulcus-bag fixation of the lens was found. Postoperative visual acuity of better than 20/40 was found in 21 patients, which is rather the same as with hard intraocular implants. According to a lower refraction index of poly-HEMA the refractive power had to be chosen about 1 dpt higher than in PMMA-lenses. Early observation of the soft intraocular implants revealed 3 decentered lenses, in later follow up 5 implants were in an excentric position. One lens removal was performed due to diplopia. 16 of 28 patients revealed capsular fibrosis after 18 months follow up, in 8 patients a YAG-capsulotomy was performed. As an advantage of soft intraocular implants of poly-HEMA a good biocompatibility can be ruled out which is demonstrated in poor cell deposits on the lens surface and no synechias. The minor tendency to adheresis seems to favour on the other hand a destable fixation of the lens, which is expressed in the number of decentered lenses, possibly also in the observed capsular fibrosis.