A patient with a history of uveitis requires cataract surgery. Which type of intraocular lens material is preferred to minimize postoperative uveitis recurrence and posterior capsule opacification in this setting?

• A PMMA (polymethylmethacrylate) with heparin surface modification
• B Silicone single-piece IOL
• C Hydrophobic acrylic IOL with sharp posterior optic edge ✓
• D Hydrophilic acrylic (hydrogel) IOL

Explanation

In uveitic patients, hydrophobic acrylic IOLs with a sharp posterior optic edge are preferred. The sharp edge creates a barrier effect against lens epithelial cell migration, reducing PCO rates — especially important in uveitis where PCO rates are high. Hydrophobic acrylic also induces less uveal inflammation than hydrophilic acrylic or silicone. PMMA with heparin surface modification was historically used for uveitis but is now less preferred than modern acrylic lenses. Silicone IOLs are contraindicated in silicone oil patients and have higher uveal reactivity.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.