Hydrophilic IOLs Increase PCO Risk in High Myopes

Since clinically significant PCO seems to develop much earlier in young high myopes with hydrophilic lenses, the authors recommend earlier intervention to reduce visual impairment. Photo: Gleb Sukhovolskiy, OD. Click image to enlarge. Posterior capsular opacification (PCO) is a common long-term complication following cataract surgery. Studies report that its development may be influenced by certain factors of intraocular lenses (IOL) such as edge design and material—particularly hydrophilic acrylic, which has been linked to PCO. Researchers in Poland and China partnered to investigate the effect of IOL material on PCO development; they confirmed in a recent BMC Ophthalmology paper that it affects outcomes in high myopes.The retrospective study included 679 highly myopic eyes that had received either hydrophilic or hydrophobic IOLs. The researchers observed that eyes implanted with hydrophilic lenses had significantly higher PCO scores than those with hydrophobic lenses. The hydrophilic group also developed clinically significant PCO over a shorter time frame compared to the hydrophobic group (42 months vs. 84 months postoperatively).Multivariate analysis showed that the PCO scores in highly myopic eyes were linked to hydrophilicity, longer follow-up duration and worse post-op BCVA. Younger age also increased the risk of clinically significant PCO in eyes implanted with hydrophilic IOLs. In patients with extreme myopia (>30mm axial length), hydrophobic IOLs reduced PCO risk the most significantly (41%).“Highly myopic eyes have larger capsular bags and thinner implanted IOLs, making it easier to form incomplete capsular-IOL interaction and thereby to develop PCO,” the authors explained in their paper. “The surface of hydrophilic IOLs has been confirmed to promote the proliferation and migration of lens epithelial cells, while the hydrophobic IOL can adhere to the collagen membrane, making the IOL tightly connected to the capsular bag, reducing the space for the migration of residual cells and thus lowering the occurrence of PCO.”The authors concluded that hydrophilic IOLs are linked to earlier and more severe PCO in high myopes. They recommend considering these risks when selecting lenses and monitoring patients postoperatively.Click here for the journal source. Zhu M, Meng J, Cheng K, et al. Long-term comparison of posterior capsular opacification in highly myopic eyes between hydrophilic and hydrophobic intraocular lenses. BMC Ophthalmol. January 24, 2026. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.