Visual significance of glistenings seen in the AcrySof intraocular lens Deepinder K. Dhaliwal, MD, Nick Mamalis, MD, Randall J. Olson, MD, Alan S. Crandall, MD, Paul Zimmerman, MD, O. Claron Alldredge, MD, F. Jane Durcan, MD, Osama Omar, MD ABSTRACT Purpose: To investigate the visual significance of "glistenings" in acrylic intraocular lenses (IOLs). Setting: John Moran Eye Center, University of Utah, Salt Lake City. Methods: Seventeen patients who had phacoemulsification with implantation of the AcrySof® acrylic IOL were evaluated by slitlamp examination and visual acuity, contrast sensitivity, and glare testing. Ten patients had a silicone posterior cham- ber IOL in the opposite eye and had testing with similar visual parameters for comparison. Glistenings noted in the acrylic IOLs were graded at the slitlamp. Laboratory analysis of five acrylic IOLs was also done to reproduce the glistenings noted clinically. Results: All 17 patients with the acrylic IOLs had some lenticular glistenings, ranging from trace to 2+. Statistical analysis of visual acuity, contrast sensitivity, and glare testing revealed a statistically significant difference between the acrylic and the silicone IOLs only in contrast sensitivity. Laboratory analysis of the acrylic IOLs showed similar glistenings from 48 to 72 hours after they were placed in balanced salt solution. Conclusions: All patients who received AcrySof IOLs that came in the AcryPak® had some degree of glistenings. There was also a significant decrease in contrast sensitivity compared with that of fellow eyes with silicone IOLs. The glistenings are likely caused by water vacuoles that form within the lens after hydration within the eyes. Further studies are necessary to assess the exact cause of these glistenings. J Cataract Refract Surg 1996; 22:452-457 T he Alcon AcrySof® intraocular lens (IOL), the first commercially available foldable acrylic 10L, was approved for marketing in the United States on Decem- ber 22, 1994. The AcrySofhas an ultraviolet blocker and poly(methyl methacrylate) haptics. Unlike foldable sili- cone 10Ls, the AcrySof has a high index of refraction (1.55) and an optic whose unfolding is slow and controlled. 1 We began implanting the AcrySof lens at the Mo- ran Eye Center, Universiry of Utah, in January 1995. Several ophthalmologists noted the appearance of "glis- tenings" in several of these 10Ls beginning about 1 week after implantation even though the lenses had appeared relatively clear on the first postoperative day. The Alcon Surgical product monograph for the AcrySof lens states that "several reports have been received that slit lamp observations, at extreme angles, revealed 'glisten- From the John Moran Eye Center, Department of Ophthalmology, Uni- versity of Utah, Salt Lake City. Presented in part at the Symposium on Cataract, IOL and Refractive Surgery, San Diego, April 1995. Reprint requests to Nick Mamalis, MD, Moran Eye Center, 50 North Medical Drive, Salt Lake City, Utah 84132. 452 J CATARACT REFRACT SURG-VOL 22, MAY 1996