Grzybowski Andrzej, Auffarth Gerd U, LaHood Benjamin R
Department of Ophthalmology, University of Warmia and Mazury, Olsztyn.
Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland.
Curr Opin Ophthalmol. 2025 Jan 1;36(1):18-24. doi: 10.1097/ICU.0000000000001095. Epub 2024 Oct 23.
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.
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.
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.
本综述总结了有关人工晶状体（IOL）材料对白内障手术结果以及手术过程本身影响的证据。
IOL材料之间的囊膜生物相容性差异导致囊膜稳定性和后囊膜混浊（PCO）出现变化，而葡萄膜生物相容性差异则影响术后炎症反应。
屈光结果受切口大小和散光IOL旋转稳定性的影响。小切口有利于使用亲水性IOL。在最近的研究中，疏水性和亲水性IOL的旋转稳定性相当。视觉结果受色差、眩光、晶状体混浊和PCO的影响。亲水性IOL与色散光减少有关。疏水性IOL混浊是由表面下闪烁引起的，而亲水性IOL混浊是由于表面钙化。一些手术，包括玻璃体切除术和板层角膜移植术，被证明会增加IOL钙化的风险，尽管其机制尚不清楚。亲水性IOL操作更简便，对IOL损伤的抵抗力更强，且葡萄膜生物相容性更高。疏水性IOL在预防PCO方面比亲水性IOL更好，在高度近视眼中应优先选用，因为钕：钇铝石榴石囊膜切开术可能会增加视网膜脱离的风险。
