Evaluation of Lens Epithelial Cell Migration In Vivo at the Haptic-Optic Junction of a One-Piece Hydrophobic Acrylic Intraocular Lens

Purpose

To evaluate the pattern of lens epithelial cell (LEC) ingrowth behind the intraocular lens (IOL) optic in patients implanted with the AcrySof SA60AT one-piece IOL.

Design

Retrospective case series.

Methods

Patients implanted with the AcrySof SA60AT one-piece IOL with complete overlap of the capsulorrhexis and IOL optic and no ocular pathology were selected from the practices of six surgeons. High-resolution digital images of the distribution of LECs were captured. Circumferential location and extent of LEC growth behind the optic were measured.

Results

Mean ± SD follow-up was 13.2 ± 1.7 months for 40 patients (mean age 72 years). LEC migration beyond the edge of the IOL optic was displayed by 57.5% (23/40) of patients. LECs migrated into the visual axis in 22.5% (9/40) of patients, leading to a visual acuity of <6/9 (20/30) in 10% (4/40) of patients. Cell migration was located preferentially at the optic-haptic junction. Serial photographs were used to monitor LEC migration over time. In some cases, LECs extended from the opposing optic-haptic junctions to converge in the center of the IOL, creating a path across the optic.

Conclusions

The optic-haptic junction of the AcrySof one-piece IOL is a point of weakness in the barrier effect of the square-edge IOL design that provides migrating LECs access to the posterior capsule.