Dear Editor,
We congratulate Ritika Chauhan and Rajesh Joshi for the world class documentation of the desiccated IOL[1] and also appreciate the decision of the editor to select the photo for publication in the IJO for better scientific interest (published in IJO, Vol 73, Issue 3, March 2025 in cover page). This photograph is an eye opener and very important document making us alert about the intraocular lens biomaterial. The clinicians before selecting the IOL do not know the biostability and biocompatibility of the particular material. This picture is a valid documentation of intraocular biomaterial degradation and bio incompatibility. In our vast country, no statistics is available regarding of the prevalence of such complication, and how many second interventions were needed particularly in the end of life stage.
In a dynamic environment polymer surface continuously changes through surface restructuring, reorientation and potential degradation influence by external factors like temperature, atmosphere and solvents. Due to viscoelastic behavior and thermaco dynamic or kinetic dependence, the polymer surface is at non-equilibrium system. This along with the other factors also depends on surface chemistry, reactivity, and morphology of polymer. Physical degradation of polymer surface is influenced by biotic and abiotic factors such as hydrolysis, photolysis, microbial degradation even by UV irradiation.[2] Ocular environment is dynamic and harsh having many of these potential risk factors.
The polymer surface characterization is implicated the structural composition of physical properties of the polymer material. Scanning electron microscopy provides high resolution images of surface characterization, atomic force microscopy offers nano scale imaging as well as major surface property, and transmission electron microscopy allows polymer internal structure and interface. The Raman spectroscopy provides chemical structure and composition of polymer. In Indian scientific research, a handful of reports are available in this perspective.[3,4,5]
The polymer surface characterization is an indicator of the status of the polymer ensuring biocompatibility and its interaction with biological tissue and fluids.[6] Previous studies show that intraocular lens made of current technology and material degrades if the IOL stays in vivo for a longer period of times. It is expected along with the progressively increasing life expectancy the intraocular lens will stay in vitreo for a longer period of time, and many IOLs will under changes which will hamper light transmission, vision impairment warranting IOL exchange. In a terminal period of life, this sort of intervention will be a cause of distress to the affected victim. In the present, photograph shows a non-planner wrinkle structure in a complex pattern due to deposition of certain biological material. The non-planner wrinkle structure of the explanted IOL polymer has been documented.[7] Aspirant reader can find the similarity.
So in this context, the IOL manufacturer can be requested to provide us the data related to IOL material bio stability and compatibility, so that a clinician can scientifically choose the product. Electron microscopy investigation of this specimen will give further insight.
Conflicts of interest:
There are no conflicts of interest.
Funding Statement
Nil.
References
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