Over 15 million cataract surgeries are performed each year world wide. 2-6 % of cataract patients suffer subsequently from diabetic and other retinal issues post surgery due to aging and accidents and must undergo a secondary eye surgery. Secondary surgery performed after implantation of artificial intra-ocular lenses (IOLs) can fail due to the fogging of IOL's from condensation of bodily fluids. New, high performance accommodating silicone and hydrophobic acrylic IOL's can fog during such surgery. This work solves the problem by modifying water affinity of IOL's using a polymer emulsion, VitreOx™ [1-5] with a 100% success rate in the lab. Ten clinical trials yielded a success rate of 80% in the year 2010-211 with failure inferred to be due to blood proteins on IOL's.

Thus, the role of hydro-affinity of blood proteins preventing coagulation, heparin, present during surgery, has to be investigated. Our results show that heparin behaves identically to H2O on hydrophobic surfaces. Heparin simply de-wets on silicone IOL's and hydrophobic acrylic lenses. It does not prevent fogging on IOL's nor interfere with our anti-fogging emulsion.

 Fibrinogen is the other protein investigated because it enhances blood coagulation and is often present in trauma situations. Fibrinogen applied to IOL's in various dilutions does prevent fogging. However, it cannot be removed after application on the IOL's, thus remaining as a potent coagulant agent in the eye. Thus fibrinogen can indeed prevent fogging, but is not viable since it cannot be removed after application like VitreOx™. Fribrinogen could explain why some IOL's fog while others do not during emergency secondary eye surgery.

[1] U. S. Patent Application “Molecular Films for Hydrophobic Implant Surfaces” N. Herbots, J. D. Bradley, M.A. Hart, D.A. Sell, S. D. Whaley, Q. Xing Bradley Filed 11/9/10

[2] "Modeling Mechanisms of Water Affinity & Condensation on Si-based Surfaces via Experiments & Applications" by Q. Xing, ASU (2011).

[3] N. Herbots, Q. Xing, M. Hart, J. D. Bradley, D. A. Sell, R. J. Culbertson, B. J. Wilkens; "IBMM of OH Adsorbates and Interphases on Si-based Materials" Nucl. Instr. & Meth. B, IBMM 17 (2010), accepted.

[4] Q. Xing, M. A. Hart, R. J. Culbertson, J. D. Bradley, N. Herbots, B. J. Wilkens, D. A. Sell, C. F. Watson;"Particle-Induced X-ray Emission of Silicate Coatings on High Impact Resistance Polycarbonates". 21st ICAARI (2010), accepted

[5] Q. Xing, N. Herbots, M. Hart, J. D. Bradley, B. J. Wilkens, D. A. Sell, C. H. Sell, H. M. Kwong, R. J. Culbertson, S. D. Whaley; "Ion Beam Analysis of Silicon-Based Surfaces and Correlation with Surface Energy Measurements?. 21st ICAARI (2010), accepted.