Glistenings 9 years after phacoemulsification in hydrophobic and hydrophilic acrylic intraocular lenses

Purpose To compare the development of glistenings after implantation of a hydrophobic acrylic intraocular lens (IOL) (AcrySof SA60AT) and a hydrophilic IOL (BL27) and evaluate the effect on corrected distance visual acuity (CDVA) and contrast sensitivity 9 years postoperatively. Setting St. Erik Eye Hospital, Stockholm, Sweden. Design Prospective randomized clinical trial. Methods One of 3 experienced cataract surgeons performed standard phacoemulsification in 1 eye of each patient. The patients were randomized to implantation of a hydrophobic acrylic IOL or a hydrophilic acrylic IOL. Both IOLs had sharp posterior edges. The CDVA and contrast sensitivity were measured 9 years postoperatively. Scheimpflug images of the IOLs were obtained to analyze glistenings, which were graded subjectively at the slitlamp and quantified objectively with digital image analysis using computer software. Results Seventy-eight of the 120 patients were available for the 9-year follow-up examination. Patients with the hydrophilic IOL had statistically significantly fewer glistenings (P < .001). The development of glistenings was not correlated with IOL power, CDVA, or contrast sensitivity. Conclusions After 9 years, the hydrophobic IOL developed more glistenings than the hydrophilic IOL. Glistenings did not affect CDVA or contrast sensitivity. Financial Disclosure Neither author has a financial or proprietary interest in any material or method mentioned.