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The effect of hypotensive drugs on intraocular lenses clarity



To assess the effect of hypotensive drugs on light absorbance, discoloration, opacification and precipitate formation of IOLs.


In this laboratory study, four types of IOLs (two hydrophilic-acrylic—L1 and L2, and two hydrophobic-acrylic—B1 and B2) were soaked in solutions containing Timolol-maleate 0.5%, Dorzolamide 2%, Brimonidine-tartrate 0.2%, Latanoprost 0.005%, Brimonidine-tartrate/Timolol-maleate 0.2%/0.5% and Dorzolamide/Timolol-maleate 2%/0.5%. Non-treated IOLs and IOLs soaked in balanced salt solution (BSS) served as controls. All Treated lenses were sealed in containers and placed in an oven at 82 degrees Celsius for 120 days. Each IOL was examined using four different techniques: light microscopy imaging, light absorbance measurements at 550 nanometers through the optic’s center, assessment of by a scanning electron microscope (SEM), and energy dispersive Xray spectrometry (EDX).


Ninety-eight IOLs were included. All BSS-soaked IOLs appeared clear with no significant discoloration or precipitate-formation. Light absorbance in these lenses was comparable to that of non-soaked, non-heated IOLs. No calcium or phosphate were detected in either of these groups. Light absorbance differed significantly between the four treated IOL types. The drops most affecting light absorbance differed between IOLs. Gross examination revealed brown and yellow discoloration of all IOLs soaked in Dorzolamide and Brimonidine-tartrate solutions, respectively. SEM demonstrated precipitates that differed in size, morphology and distribution, between different IOL-solution combinations. EDX’s demonstrated the presence calcium and phosphor in the majority of precipitates and the presence of sulfur in brown discolored IOLs.


In vitro, interactions between hypotensive drugs and IOLs induce changes in light absorbance, discoloration and precipitate formation.

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Fig. 1: Different phenomena identified by gross inspection.
Fig. 2: Discoloration of IOLs.
Fig. 3: Precipitates.
Fig. 4: Light absorbance.

Data availability

The data that support the findings of this study are not openly available due to the specific condition of the IOL donators. Data are available from the corresponding author upon reasonable request and may be shown under blindness of the IOL manufacture and model.


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The authors would like to acknowledge Professor Graham Trope for his inspiration and for his support of this project.

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Authors and Affiliations



TS conceived and directed the project and wrote the manuscript. LNBH collected data, performed statistical analysis and critically revised the manuscript. NR, DK and AK collected data, YT, ALE and EIA contributed to the discussion and critically revised the manuscript. AB conceived the project, wrote the manuscript and directed the project.

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Correspondence to Tal Sharon.

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This study was exempted by the Institutional Review Board (IRB) at Meir Medical Center, since no use of human data was used.

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Sharon, T., Naftali Ben Haim, L., Rabinowicz, N. et al. The effect of hypotensive drugs on intraocular lenses clarity. Eye (2022).

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