Dr. Matsushima explains why opacification is more common in hydrophilic IOLs compared with hydrophobic IOLs. Using scanning electron microscopy, he shows that the surface of explanted opacified hydrophilic IOLs have dense deposits of calcium, while the surface of the hydrophobic IOL had no deposits. Examination of a cross-section of the hydrophobic lens reveals nanometer-sized water particles distributed widely throughout its outer layers. This markedly different character in opacification is the reason why patients with opacified hydrophilic IOLs complain of poor vision, as the dense calcium deposits degrade the transmission of light.

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