Influence of Haptic Materials on the Adherence of Staphylococci to Intraocular Lenses

A recent case-control study indicated that the insertion of an intraocular lens with polypropylene (Prolene) haptic materials was a significant risk factor for postoperative endophthalmitis (odds ratio=4.5, P<.01). In the present study, we used quantitative techniques to evaluate adherence of Staphyloccocus epidermidis to two intraocular lens types—lenses with polypropylene haptic materials and all-polymethyl methacrylate optic and three-piece all-polymethyl methacrylate lenses—using a quantitative culture method, a radioisotope technique, and scanning electron microscopy. All three methods demonstrated approximately twice as many bacteria adherent to lenses with polypropylene haptic materials as to all-polymethyl methacrylate lenses. Scanning electron microscopy showed preferential bacterial adherence to the polypropylene haptic materials. These data provide a pathogenic mechanism to explain our epidemiologic findings of an increased risk of postoperative endophthalmitis associated with implantation of intraocular lenses with polypropylene haptic materials.