الفهرس 
Capsular biocompatibilityOnly 14 pages are availabe for public view
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Abstract
The aim of the work: Evaluating the uveal and capsular biocompatibility of 3 types of foldable IOLs comparing . Material & Method : This prospective study comprised (107) eyes of (95) patients with a followup period between 12 to 18 months. Patients were randomized to receive 1 of 3 foldable IOLS hyDROPhobic acrylic; hyDROPhobic silicone; hyDROPhilic acrylic and hyDROPhobic PMMA as control group. Specular microscopy was used to identify the presence of cell deposits on the IOL surface. The study intended to produce a set of digital retro illuminated photographs of PCO, ACO and ACR from the patients included in this study and have used subjective method for evaluation of capsular opacification and capsular phimosis. Results : Regarding age, sex and lens grade distribution among the 4 IOL groups there was no statistically significant difference (p = 0.647, p = 0.495).Highest incidence of small rounded cells occurred in patients implanted with hyDROPhilic acrylic lenses (CentreFelex, 44.0%). HyDROPhobic acrylic lens group (Sensar AR40e, 42.09%) showed higher affinity for FBGCs than did the silicone and hyDROPhilic lenses (Phacoflex, 4.2% CentreFelex, 8.0%) (P=0.002 within the 2nd month).The entire patients showed grade 0.0 cellular reaction in the anterior chamber within the 3rd week. There was no statically significant difference between lens groups .Lens epithelial cells proliferation on the capsule free anterior surface occurred more with the hyDROPhilic acrylic lens group (CentreFelex, 52.0%). Silicone lenses showed strongest sings of ACO and capsular phimosis (Phacoflex, 54.02%) (P=0.0004). There was no statistically significant difference among the 4 IOL groups regarding the score of PCO in the central 3.0 mm zone using EPCO2000 soft ware (P=0.415). Lowest incidence of PCO outside the central 3.0 mm of the lens optic occurred in hyDROPhobic acrylic lens group (4.8% of eyes implanted with this IOL reached grade 3.0 PCO).In patients implanted with lenses having sharp optic edge( the PMMA lens group and the hyDROPhilic acrylic lens group) Elschnig pearls remained confined to the area outside the lens optic and prevented from passing behind the lens optic by the sharp optic edge. Conclusion : The study concluded that although, the specular reflex on the IOL surface is a good method to study the surface cytology but there was difficulty to obtain uniform bright reflex on different IOLS with different refractive indices. Thus, obtaining a comparable result using this technique is a hard task represents a matter of exhaustion to the examiner and the patient. EPCO2000 soft ware is a good method to obtain comparable scores for PCO but have the limitation of being subjective. The hyDROPhilic acrylic lenses showed better uveal biocompatibility compared to the other groups. HyDROPhobic acrylic lenses as a material showed better capsular biocompatibility with lowest incidence of PCO. PMMA lens showed middle position regarding both capsular and uveal biocompatibility. Sharp optic edge of the lens represent a mechanical method to limit the spread of PCO to the central areas rather than to prevent it. LEC proliferation on the IOL surface is a reflect to the material tolerance by the eye thus, lenses showed better uveal biocompatibility are those showed better LEC proliferation on the IOL surface. The reaction of the anterior capsule to the lens is a material dependant with marked anterior capsular fibrosis with the hyDROPhobic materials.