Original Paper

Received: December 13, 2002

Accepted: April 23, 2003

Ophthalmologica 2004;218:5763
DOI: 10.1159/000074568

Material Properties of Various

Intraocular Lenses in an Experimental
Study
Mana Tehrani a, c H. Burkhard Dick a Beate Wolters a Tadeusz Pakula b
Evan Wolf c
a Department

of Ophthalmology, Johannes Gutenberg University, and b Max Planck Institute for Polymer Research,
Mainz, Germany; c John A. Moran Eye Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA

Abstract
Introduction: With the recent introduction of small-incision cataract surgery, requirements for intraocular lens
(IOL) flexibility, strength and hydrophilicity have rapidly
evolved. The IOL surface, however, remains a critical factor influencing uveal biocompatibility. Purpose: To objectively quantify factors of material properties of various IOLs using contact angle measurements, differential
scanning calorimetry, dynamic-mechanical measurements and scanning electron microscopy. Material and
Methods: In our study, 17 currently available IOLs were
investigated using contact angle measurements to assess hydrophilicity and biocompatibility, as well as differential scanning calorimetry for the estimation of glass
transition temperature. Mechanical capacity and flexibility were investigated using dynamic-mechanical measurements. Additional analysis of the IOL surface was
performed using scanning electron microscopy. Results:
The contact angle measurements of the studied IOLs
revealed similar values within each group. The silicone
IOLs had values between 106 and 119. The PMMA IOLs

ABC

2004 S. Karger AG, Basel

00303755/04/21810057$21.00/0

Fax + 41 61 306 12 34
E-Mail karger@karger.ch
www.karger.com

Accessible online at:

www.karger.com/oph

were found to have a narrower range of values, between

73.2 and 75.5. Lenses made of hydrogel had values
between 59.2 and 69.1. The heparin-modified surface
showed the lowest contact angle of 56.5 . The glass transition temperature was determined by dynamic differential scanning calorimetry. The resulting values were
between 118.8 and 113.5 C for PMMA IOLs, 15.5 and
14.0 C for acrylic IOLs, and 91.7 and 119.6 C for silicone IOLs. The dynamic-mechanical measurements revealed that PMMA lenses manifested characteristics
similar to glass, whereas silicone lenses had characteristics similar to rubber. Acrylic lenses were between rubber and glass. Scanning electron microscopy revealed
smooth dispersion of fibrin on hydrophobic IOLs and a
relative lack of fibrin adhesion on hydrophilic materials.
Conclusion: These results demonstrate that material
properties of various IOL materials are consistent within
classes of IOL materials. This suggests that the intraoperative and postoperative behavior of an IOL is predictable
and related to its composition, thus allowing surgeons to
choose IOLs more appropriate for different surgical situations and individual patient characteristics.
Copyright 2004 S. Karger AG, Basel

Mana Tehrani, MD
Johannes Gutenberg University
Department of Ophthalmology, Langenbeckstrasse 1
DE55131 Mainz (Germany)
Tel. +49 6131 173130, Fax +49 6131 175566, E-Mail manatehrani@hotmail.com

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Key Words
Material properties W Intraocular lens W Hydrogel

In the last 50 years, the intraocular lens (IOL) has

undergone innumerable modifications in terms of design
and material. It was 1949 when H. Ridley implanted the
first polymethylmethacrylate (PMMA) IOL. Since that
time this material has proven to be quite biocompatible.
IOL placement has also progressed from angle fixation to
iris fixation and finally to placement into the capsular bag
with a J loop [1]. With the beginning of phacoemulsification in the 60s, the search for a foldable material that
would allow small-incision surgery with all its advantages
led to the development of a series of new foldable materials [2]. These materials allow the use of a 2- to 3.5-mm
incision for lens implantation and can be divided into
2 groups: the acrylate/methacrylate group, containing
PMMA, hydrogel or acrylic, and the silicone group. The
difference between the foldable acrylic and the rigid
PMMA lenses lies in a change in the side chain of the
methacrylic backbone. Many different side chains have
been used within this group so that each IOL differs in
water content, refractive index, folding and unfolding
behavior and surface characteristics. From 1986 to 1997,
PMMA was the most frequently used IOL material, but
since 1998, foldable acrylic has essentially replaced
PMMA in clinical practice [3].

Cellular deposition on the IOL surface is a good indicator of postoperative inflammatory reaction and biocompatibiliy [46]. The extent of this cellular reaction depends on the material, design and biocompatibility of the
IOL used [7]. There is no doubt that material properties
influence the biological response, and the IOL surface
may be the most important factor influencing biocompatibility, due to its direct interaction with intraocular tissue, proteins and inflammatory mediators.
The purpose of this study is to objectively quantify the
material characteristics of currently available IOLs, using
the methods described below. This information is potentially relevant to the surgeon faced with the task of choosing the most appropriate IOL for a clinical or surgical situation.

Material and Methods

We measured several physical properties and surface characteristics of currently available lenses that have direct bearing on their biocompatibility. Seventeen commercially available sterile IOLs of different materials and manufacturers were studied (table 1): the AcrySof MA60BM (Alcon), AMO PS 101 A, AMO PhacoFlex SI-40 NB,
AMO AR-40 (Allergan), C11UB, Soflex 2, Easacryl 1, Silens 6, Siflex

Table 1. Characteristics of 17 commercially available IOLs of various manufacturers and contact angle results of the

representative IOLs
IOL type/manufacturer

Chemical composition

IOL design

IOL material

CeeOn 811C/Pharmacia
SC60B-UV/MDR (f)
ACR6D/Corneal (f)
92L/Morcher (f)
Hydriol 28C/PhysIOL (f)
U940A/Mentor Ophthalmics (f)
Easacryl 1/Bausch & Lomb (f)
PS 101 A/Allergan
MA60BM/Alcon (f)
Siflex 4/Bausch & Lomb
Flex 60/Bausch & Lomb
CeeOn 740P/Pharmacia
AR-40/Allergan (f)
SI-40 NB/Allergan (f)
Soflex 2/Bausch & Lomb (f)
C11UB/Bausch & Lomb (f)
Silens 6/Bausch & Lomb (f)

HSM, PMMA
HEMA
HEMA (26% water)
MMA, HEMA (28% water)
HEMA
MMA, HEMA, EGDMA
HEMA (26% water)
PMMA
PEA, PEMA
PMMA
PMMA
PMMA
EA, EMA, TFEMA
PDMDPS
PDMS
PDMS
PDMS

one-piece
one-piece
one-piece
three-piece
one-piece
three-piece
one-piece
one-piece
three-piece
one-piece
one-piece
one-piece
three-piece
three-piece
three-piece
one-piece
three-piece

HSM, PMMA
HEMA
HEMA
PMMA
HEMA
polypropylene
HEMA
PMMA
PMMA
PMMA
PMMA
PMMA
PMMA
PMMA
PMMA
PDMS
PMMA

Contact angle
degrees
56.5B3.8
59.2B2.5
64.3B1.8
64.6B1.2
64.9B2.4
65.2B3.1
69.1B1.7
73.2B1.4
73.3B2.4
75.4B1.2
75.7B2.9
77.1B4.2
81.7B1.3
106.2B1.4
112.9B1.7
115.4B1.3
199.0B3

f = Foldable; EA = ethylacrylate; EGDMA = ethyleneglycol dimethacrylate; EMA = ethylmethylacrylate; HEMA =

hydroxyethylmethacrylate; HSM = heparin-modified surface; MMA = methylmethacrylate; PDMS = polydimethylsiloxane; PDMDPS = polydimethyldiphenylsiloxane; PEA = phenylethylacrylate; PEMA = phenylethylmethacrylate;
TFEMA = trifluorethylmethacrylate.

Ophthalmologica 2004;218:5763

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58

Contact Angle Measurement

The contact angle measurement was performed to provide information about the hydrophilicity of the various lens materials. The
basis of the contact angle measurement lies in the fact that the
spreading of a drop on a surface is related to physical-chemical forces
between the liquid and the material [8]. The sessile-drop method in
air was used to quantify wetting ability, an indicator of hydrophilicity. The contact angle reading taken is the angle between the bordering surfaces, in this case formed between the IOL and the water
surface. The wetting ability (and therefore hydrophilicity) is inversely proportional to the contact angle and to surface tension.
The contact angle measurements were performed with 4 PMMA
lenses (PS 101 A, Siflex 4, Flex 60, CeeOn 740P), 1 PMMA lens with
a heparin-modified surface (CeeOn 811C), 4 silicone lenses (SI-40
NB, Soflex 2, C11UB, Siflex 6) and 8 acrylic lenses (SC60B-UV,
ACR6D, 92 L, Hydriol 28C, Memorylens, Easacryl 1, PS 101 A,
Acrysof). Six measurements were obtained for each lens with a Goniometer (G1, ERMA Optical Limited, Tokyo, Japan).
Differential Scanning Calorimetry
We were interested in the ideal temperature for optimal unfolding within the eye and therefore used differential scanning calorimetry to assess the glass transition temperature of the various IOLs.
With this technique, energy that is absorbed or released from a material is measured along a spectrum of temperatures.
The measuring apparatus was provided by Mettler-Toledo, Switzerland, and the unit (TC 15 TA controller) consists of the heating
stoves (Mettler DSC 30) and equipment that passes the triggering
signals from the stove to the computer (software: STARS).
Dynamic-Mechanical Measurements
The mechanical capacity and flexibility of the selected IOLs were
also studied. To document viscoelastic properties, dynamic-mechanical measurements were performed. An important parameter is e.g.
the elasticity modulus which represents the relation between the elastic pressure and the applied strain. During the measurements, the
device applies a definite force of gravity and measures the response
of the material. Dynamic-mechanical measurements were performed
to investigate these characteristics using the spectrometer from the
IMASS company.
Scanning Electron Microscopy
In order to assess collection or rejection of biologic materials on
the surfaces of the various IOLs, scanning electron microscopy was
performed. The IOLs were first layered with 0.00207 g of human
fibrin (Tissucol-Kit, Immuno GmbH, Heidelberg, Germany). Then,
the IOLs underwent sputtering with gold for 35 min (Edwards Sputtercoater S150B). The surfaces were then evaluated with a scanning
electron microscope using the Hitachi S-520 (Hitachi Ltd., Tokyo,
Japan; camera, Model S-5080, Hitachi).
With the exception of the scanning electron microscope measurements, all other investigations were performed in the Max Planck
Institute for Polymer Research in Mainz, Germany. The differential
scanning calorimetry and the dynamic-mechanical measurements
were performed with representatives of the IOL material categories:

Material Properties of Various Intraocular

Lenses

MA60BM/Alcon; Flex 60/Bausch & Lomb; CeeOn 811C/Pharmacia;

SI-40 NB/Allergan; C11UB/Bausch & Lomb; Hydriol 28C/PhysIOL;
ACR6D/Corneal; 92L/Morcher; U940A/Mentor Ophthalmics; AR40/Allergan, and Easacryl 1/Bausch & Lomb. The scanning electron
microscope measurements were conducted in the Department of
Laboratory Sciences in Mainz.

Results

Contact Angle Measurements

The contact angle measurements for all the IOLs can
be found in table 1. The materials with a siloxane backbone had similar contact angle values ranging from 106.2
B 1.4 to 119.0 B 3, with the PhacoFlex II SI-40 NB
having the lowest. The methacrylate group revealed lower
contact angles compared to the siloxane group. Of the
acrylic lenses, the PS 101 A had the lowest value, 73.2 B
1.4. The heparin-modified IOL showed the lowest contact angle of all lenses tested with a value of 56.5 B 3.8
(table 1).
Differential Scanning Calorimetry
The PMMA IOL CeeOn 811C showed glass transition
temperatures of 118.8 C and the Flex 60 of 113.5 C. The
92L and the U940A had values of 111.2 (92L) and
109.9 C. The Hydriol 28C, Easacryl 1 and ACR6D had
mean glass transition temperatures of 108.7, 105.0 and
95.9 C, respectively. The AR-40 and AcrySof MA60BM
had lower values, between 15.5 and 14.0 C. The silicone
lenses SI-40 NB and C11UB had negative values of 91.7
and 119.6 C.
Dynamic-Mechanical Measurements
The rigid PMMA IOL, Flex 60 and the Memory IOL
demonstrated spectroscopic properties similar to glass.
The hydrogel lenses (92L, ACR6D, Hydriol 28C and Easacryl 1) were in the half-elastic state. The group of acrylic
lenses (AcrySof and AR-40) had intermediate properties.
The silicone lenses C11UB and SI-40 NB showed rubberlike characteristics (fig. 1). Our analyses showed that the
silicone lenses unfold independently of the temperature,
leading to a fast unfolding process, whereas the acrylic
and the hydrogel IOLs ensure a slow and controlled
unfolding.
Scanning Electron Microscopy
In acrylate/methacrylate lenses, an even distribution of
fibrin was observed. Exceptions were the Siflex 4 and PS
101 A, where the fibrin was piled up (fig. 2).

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4, C11UB and Flex 60 (Bausch & Lomb), CeeOn 740P and CeeOn
811C (Pharmacia), Memorylens U940A (Mentor Ophthalmics), 92L
(Morcher), Hydriol 28C (PhysIOL), ACR6D (Corneal) and the
SC60B-UV (Medical Development Research).

Fig. 1. Graphic representation of the results of dynamic-mechanical measurements. The IOLs are ordered according
to their mechanical capacity between rubber and glass. log E) = Elasticity modulus, which is defined as the relationship of elastic pressure in phase to the applied force and is dependent on the ability of a substance to store energy
elastically [1]; log E)) = viscosity modulus, which describes the viscous part of a viscoelastic system; the higher the
viscosity, the higher the value of the viscosity modulus [1]; Tg = glass transition temperature.

60

Ophthalmologica 2004;218:5763

Discussion

Biocompatibility is defined as the capability of a prosthesis implanted in the body to exist in harmony with tissue without causing deleterious changes [911]. Further,
uveal and capsular biocompatibility have been differentiated. The foreign-body cellular reaction can be seen as
the most important parameter for uveal biocompatibility.
Thus, IOLs causing relatively less foreign-body reaction
can be described as uveally biocompatible. The main
determinants of capsular biocompatibility are lens epithelium cell outgrowth, anterior and posterior capsular opacification and capsular contraction [9, 10].

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The silicone group had minor dispersion, with fibrin

plates nearly peeled off of the SI-40 NB and C11UB. In
contrast, the Silens 6 and Soflex had piled fibrin.
The 2 hydrophobic acrylic lenses MA60BM and AR40 showed a similar and even dispersion of fibrin on their
surface. The transition of the edge of the fibrin to the surface of the IOL was not flat like in the other IOLs of this
group. Rather, a rounded interface configuration was seen
(fig. 3).

Fig. 3. Scanning electron image of a threepiece foldable acrylic IOL (AR-40/Allergan)

shows minor dispersion of the fibrin, with a
well-defined limitation of the fibrin and
hardly contact zones to the surface of the
IOL. Magnification !25.

The purpose of this study was to quantify potentially

relevant parameters of foldable IOL material properties
and biocompatibility so that surgeons may have data on
currently available IOLs and a paradigm for predicting
the clinical behavior of new products as they emerge.
Like all prostheses, the interaction of an IOL with the
intraocular environment is influenced by its material
properties. We studied several material properties of 17
commercially available IOLs. Contact angle measurements were obtained to assess hydrophilicity. Differential
scanning calorimetry was performed to assess the optimal
temperature of the IOL for implantation. Dynamic-mechanic measurements were performed to investigate ca-

Material Properties of Various Intraocular

Lenses

Ophthalmologica 2004;218:5763

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Fig. 2. Scanning electron image of an onepiece PMMA IOL (PS 101 A/Allergan). The
image from the side view revealed fibrin
accumulation in height. Magnification
!52.

pacity and flexibility. A descriptive analysis of lens surface interaction with fibrin was performed using scanning
electron microscopy.
The contact angle measurements revealed similar angles within the material groups, but differences between
material groups. Minor differences could be seen in the
silicone group with values between 106.2 B 1.4 and 119.0
B 3. Within the PMMA/acrylic group, the values again
had minor differences: PS 101 A, AcrySof MA60BM,
Siflex 4 and the Flex 60 had similar values (73.2, 73.3,
75.4 and 75.7). The AR-40 from Allergan had a higher
value, 81.7. In the hydrophilic group, the values ranged
between 59.2 B 2.5 (SC60B-UV/MDR) and 69.1 B 1.7
(Easacryl 1/Bausch & Lomb). The lowest value of any lens
was seen in the heparin-surface-modified IOL (56.5 B
3.8).
Contact angle readings in particular assess surface
hydrophilicity, which can be used as a reliable parameter
for predicting uveal and capsular biocompatibility [12].
The heparin-surface-modified IOL revealed the lowest
contact angle values. Tognetto and Ravalico [13] described less anterior segment inflammation in terms of
reduction of postoperative inflammatory cell response,
fibrinoid reaction and synechia formation in eyes which
had received heparin-surface-modified PMMA lenses
compared to those with normal PMMA lenses. Miyake et
al. [14] found that IOLs with hydrophobic surfaces induced higher postoperative inflammation than lenses
with hydrophilic surfaces. Amon et al. [9] have described
a significantly lower incidence of foreign-body reactions
on hydrophilic than on hydrophobic IOL surfaces and
conclude that the best approach to improve biocompatibility of IOL material is to reduce protein adhesion, e.g.
with hydrophilic IOLs. Especially for eyes with preoperative risk factors for foreign-body reaction, IOLs with
hydrophilic surfaces should be recommended [9].
Hollick et al. [15] described a reduced inflammatory
cell reaction in hydrophilic lenses compared with PMMA
and silicone IOLs but with many more lens epithelial cells
on the anterior surface. In contrast, Miyake et al. [14]
found a correlation between the hydrophilicity of an IOL
and the severity of postoperative inflammation (alteration of the blood aqueous barrier) and the speed of anterior capsule opacification. Hydrophobic lenses induced
greater postoperative inflammation and more rapid anterior capsule opacification [16].
Overall, these findings suggest that the contact angle of
a material, as a value for hydrophilicity, is a reliable basic
parameter for predicting uveal and capsular biocompatibility. Together with clinical observations, this informa-

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Ophthalmologica 2004;218:5763

Perhaps equally as important, however, in postoperative cellular reactions is IOL design [17]. Does IOL material play only a minor role in posterior chamber opacification while the design of the IOL is the major determinant?
In fact, several studies have established that a sharp optic
edge design is associated with significantly reduced posterior chamber opacification [18, 19].
In summary, there are many parameters influencing
the biocompatibility of IOls. IOL material, and in particular its surface properties [20], as well as its design/shape
are important in determining the clinical behavior of the
lens in vivo. Taken together with known preoperative risk
factors, such as glaucoma, diabetes mellitus, pseudoexfoliation or uveitis [21], proper IOL selection may result in
superior postoperative results. This has been borne out by
a reduced inflammatory response for routine glaucoma,
uveitis and diabetes patients with the heparin-surfacemodified IOLs, as compared with non-heparin-surfacemodified lens implants.
In the future, IOL materials and designs may be routinely tested in vitro to understand their interactions with
cells, proteins and tissues, thus streamlining the process of
product development and making surgery safer and more
predictable for patients [1, 12, 20].

Conclusion

Several material properties of many popular IOLs were

investigated. With this information, surgeons may select
IOLs more knowledgeably for their patients with intraoperative challenges (miosis, capsular tear, zonular dehiscence) or conditions predisposing to inflammation, increased intraocular pressure and capsular opacification
(diabetes, glaucoma, uveitis, angle trauma, youth). For
example, in patients with pseudoexfoliation syndrome
having miosis and capsular friability, a surgeon may
choose an IOL that unfolds slowly or achieve this by
changing the temperature of the IOL before insertion.
A further example is that a foldable, relatively hydrophilic IOL might be used in patients with chronic uveitis,
rather than using a rigid PMMA lens requiring a larger
incision.
Hopefully the results of this study will help surgeons
choose IOLs and promote improved postoperative visual
outcomes by adding experimental data to the existing
empirical clinical data on todays IOLs. Further, this type
of study may aid in product development, by establishing
relevant and reliable biocompatibility testing paradigms.

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tion can guide the choice of IOL based on the clinical situation.
Differential scanning calorimetry, which measures
glass transition temperature, gives us additional information about the IOLs. The classic PMMA lenses have a
glass transition temperature of approximately 110 C so
that at room temperature this material is in a brittle, glass
status. Our analysis revealed mean glass transition temperatures of 113.5 C (Flex 60 from Bausch & Lomb) and
118.8 C (CeeOn 811C from Pharmacia, surface modified) for modern PMMA lenses.
Glass transition temperatures are especially important
for foldable IOLs. The hydrogel IOLs are as rigid as Plexiglas when dehydrated and are related to PMMA lenses, as
they are acrylate/methacrylate polymers. At room temperature, in a dehydrated state, hydrogel lenses are rigid
and fragile. These lenses become soft and elastic when
hydrated. The measurements had to be taken in the dehydrated state, so these values likely differ from that of the
hydrated state.
The acrylic lenses had a mean glass transition temperature of 14.0 C. Thus, by warming, a faster unfolding of
the lens can be achieved. Alternatively, implantation at
room temperature allows slower unfolding within the eye.
The silicone lenses revealed rubber-like characteristics at
room temperature. This correlates with clinical intraoperative experiences of very rapid unfolding within the eye.
The dynamic-mechanical measurements revealed that
the PMMA lenses remained in the glass state. The hydrogel lenses were in the half-elastic state. The acrylic lenses
had values between the half-elastic and glass state. They
unfold slowly within a temperature range of 10 C, which
allows a controlled unfolding process. The silicone lenses
demonstrated a high returning resilience which contributes to a powerful unfolding during implantation. The
returning resilience was independent of the temperature.
Scanning electron microscopy confirmed that fibrin, a
non-water-soluble protein, withdraws from hydrophilic
surfaces and adheres to hydrophobic surfaces. In the
hydrophobic PMMA and acrylic groups, an intense adhesion could be observed, and in the silicone IOLs, the
fibrin was spread widely. In the SI-40 NB and the C11UB,
the fibrin was peeled off from the surface.
Biological interactions are influenced by material surface properties. Property studies can yield information for
a better understanding of material interactions [12].
Our findings are results from measurements in an artificial environment but correlate with empirical experience and provide new, comparative information for the
different IOLs investigated.

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Material Properties of Various Intraocular

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