Hydrophilic vs hydrophobic: which is the better option?


Dr Christophe Chassain believes blue-blocking square-edged hydrophilic lenses are just as safe as their hydrophobic counterparts

Hydrophilic vs hydrophobic: which is the better option?

"Hydrophilic IOLs tend to be easier for the surgeon to implant, and are therefore, particularly in the case of very small incisions, probably a more suitable surgical option than hydrophobic IOLs," said Christophe Chassain, MD, an anterior segment surgeon at the Clinique Beau-Soleil, Montpellier, France. "Postoperatively, though, hydrophilic lenses have a worse reputation for prevention of posterior capsule opacification (PCO), which traditionally has been a prime metric used to determine the success of IOL implantation."

Related: Posterior corneal elevation: Is there a role for premium IOLs?

PCO: investigating hydrophilic IOLs

The SlimFlex is a 26% hydrophilic monobloc IOL with a 6 mm optic, and a 360° posterior square edge. It has an overall diameter of 10.5 mm, with four haptics at a 5° angle. The lens can be injected through a 2.4 mm incision. MicroSLIM - the microincision version of the lens, which can be injected through a 1.8 mm incision - is made from 25% hydrophilic material.

Dr Chassain implanted 344 SlimFlex lenses into 191 female and 153 male subjects with a mean age of 77 years (range: 46–94 years) and a mean dioptric power of +20.5 D (range: 9–28 D). Topical anaesthesia was used and, during the coaxial surgery, the posterior capsule was cleaned; FlexiRing intracapsular rings (IOLTECH Laboratories) were implanted into 34 eyes. A rhexis of 5.5 mm was achieved in 66% of cases; the rhexis IN position was 76% with an optic overlap.

Related: No toric? No problem: Small-aperture optics can mitigate astigmatism

Similar PCO rates with both lens types

"Of the 344 subjects implanted with the SlimFlex lens, 3.2% required further treatment with Nd:YAG posterior capsulotomy to combat PCO. Of these, four YAGs were performed in the 180 eyes with an IN rhexis; six in the 57 eyes with an IN/OUT rhexis; one in the four eyes with posterior fibrosis, and two in the 34 eyes implanted with a FlexiRing," reported Dr Chassain.

The mean follow-up period was 20.6 months (range: 11–28 months). At this stage, 68.6% of subjects had achieved a clear central posterior capsule.

Related Content: Cataract & Refractive | Inflammation & Infection | Cornea

Related Videos
ARVO 2024: Andrew D. Pucker, OD, PhD on measuring meibomian gland morphology with increased accuracy
 Allen Ho, MD, presented a paper on the 12 month results of a mutation agnostic optogenetic programme for patients with severe vision loss from retinitis pigmentosa
Noel Brennan, MScOptom, PhD, a clinical research fellow at Johnson and Johnson
ARVO 2024: President-elect SriniVas Sadda, MD, speaks with David Hutton of Ophthalmology Times
Elias Kahan, MD, a clinical research fellow and incoming PGY1 resident at NYU
Neda Gioia, OD, sat down to discuss a poster from this year's ARVO meeting held in Seattle, Washington
Eric Donnenfeld, MD, a corneal, cataract and refractive surgeon at Ophthalmic Consultants of Connecticut, discusses his ARVO presentation with Ophthalmology Times
John D Sheppard, MD, MSc, FACs, speaks with David Hutton of Ophthalmology Times
Paul Kayne, PhD, on assessing melanocortin receptors in the ocular space
Osamah Saeedi, MD, MS, at ARVO 2024
© 2024 MJH Life Sciences

All rights reserved.