Animal model experimentation using the expansile hydrogel intraocular lens

Preparation and Stability Study of an Injectable Hydrogel for Artificial Intraocular Lenses

Currently available intraocular lenses (IOLs) on the market often differ significantly in elastic modulus compared to the natural human lens, which impairs their ability to respond effectively to the tension of the ciliary muscles for focal adjustment after implantation. In this study, we synthesized a polyacrylamide-sodium acrylate hydrogel (PAH) through the cross-linking polymerization of acrylamide and sodium acrylate. This hydrogel possesses excellent biocompatibility and exhibits several favorable properties. Notably, the hydrogel demonstrates high transparency (94%) and a refractive index (1.41 ± 0.07) that closely matches that of the human lens (1.42). Additionally, it shows strong compressive strength (14.00 kPa), good extensibility (1400%), and an appropriate swelling ratio (50 ± 2.5%). Crucially, the tensile modulus of the hydrogel is 2.07 kPa, which closely aligns with the elastic modulus of the human lens (1.70-2.10 kPa), enabling continuous focal adjustment under the tension exerted by the ciliary muscles.

Permanent blue discoloration of a hydrogel intraocular lens by intraoperative trypan blue

A 79-year-old white man had cataract surgery in the right eye with implantation of an Acqua intraocular lens (IOL) (Mediphacos). Trypan blue 0.1% was used during surgery to stain the anterior capsule and enhance the contrast during capsulorhexis. Seven days after surgery, the patient presented with "dark and double" vision (monocular diplopia). The IOL was decentered superiorly and appeared dark blue. The lens was explanted 2 months after surgery and sent for gross and microscopic analyses in a dry state and after hydration. The same analyses were performed on 2 unused lenses of the same design that had been immersed in diluted trypan blue solutions (0.01% and 0.001%). On the explanted lens, the dark blue staining was denser in the optic, especially in its periphery. The blue discoloration could not be removed after 24 hours of lens immersion in a balanced salt solution at 37 degrees C. Permanent staining of the unused lenses was also obtained after immersion in the trypan blue solutions.

Assessing intraocular lens calcification in an animal model

PURPOSE

To describe an animal model used to evaluate the propensity of various biomaterials to calcify intraocularly.

SETTING

Research Department, Allergan Inc., Irvine, California, USA.

METHODS

Intraocular lens (IOL) optic materials were implanted intramuscularly and/or subcutaneously in rabbits for up to 90 days. The materials included silicone, poly(methyl methacrylate) (PMMA), hydroxyethyl methacrylate hydrogel, and several hydrophobic acrylic materials. Scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDS) were used to detect calcification demonstrated by characteristic discrete nodules containing both calcium and phosphate. Histological methods were used to evaluate tissue reactivity. Disc lenses fabricated from the experimental material were also bilaterally implanted in rabbit eyes that were monitored by slitlamp biomicroscopy. The lenses were explanted at 1, 2, 5.5, 10, and 20 months for SEM/EDS analysis.

RESULTS

No calcification was noted in the intramuscularly or subcutaneously implanted silicone, PMMA, and acrylic optic materials. Calcification was noted on the intramuscularly, subcutaneously, and intraocularly implanted experimental acrylic and the intramuscularly implanted hydrogel material; the calcification was more extensive on the hydrogel. Signs that suggested intraocular calcification were first noted on the experimental IOLs at 4 months, but calcification was not confirmed until 10 months.

CONCLUSIONS

Material calcification occurred more quickly in an intramuscular or subcutaneous environment than in an intraocular environment. Intramuscular and subcutaneous implantation appears to be an excellent model for screening materials for calcification potential. However, calcification is both host environment and material dependent. Using intramuscular or subcutaneous implantation in animal models to predict intraocular calcification in humans must be done with caution.