Glistenings in hydrophobic acrylic intraocular lenses do affect visual function

Abstract

George HH Beiko,1,2 Andrzej Grzybowski3,41Department of Surgery, McMaster University, Hamilton, ON, Canada; 2Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; 3Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland, 4Department of Ophthalmology, Poznan City Hospital, Poznan, Poland We recently read the paper "Evaluation of in vitro glistening formation in hydrophobic acrylic intraocular lenses" by Thomes and Callaghan.1 The paper is extremely interesting in that the authors, employees of Alcon Research Ltd (Forth Worth, TX, USA), report not only that Alcon lenses have glistenings, but also that "continuous improvements on glistening formation"1 have been made by Alcon over the years from 2003 to 2012. We congratulate the authors and Alcon on their efforts, and on making this admission.The paper raises a number of concerns and questions. Firstly, the statement in the introduction, "Glistenings are typically observed within a few months of surgery and plateau approximately 1 year after surgical implantation of the [intraocular lens] IOL"1 is not referenced. The reported literature is in contradiction to this statement, in that the glistenings formation, as well as the severity of glistenings, has been reported to increase with longer follow-up times.2–8 Very few studies that evaluate the progression beyond one year find glistening formation to be stable.9–10 In addition, this statement is contradicted by the authors themselves in the introduction section of this paper where they state that a study by Colin et al4 found that 73.8% of the IOLs had glistenings when follow-up was less than 2 years, and 94.2% of the IOLs had glistenings when the follow-up was longer than 2 years. Even after10 years of follow-up, no plateau was seen.2View original paper by Thomes and Callaghan.