A major attention is focused at present to the surface characteristics of intraocular lenses (IOLs), which determine the biological response to the prostheses. There is now an overwhelming information on the fact that some cell types adhere to a lesser extent onto heparin-surface-modified (HSM) polymethylmethacrylate (PMMA) IOLs, either in vitro and in vivo. The present work aimed at sheding new insights by applying ultrastructural techniques of analysis. Our results basically confirm that human fibroblasts, platelets and monocytes are less in number when cultured onto HSM PMMA IOLs as compared to untreated PMMA IOLs. In addition: (1) the submicroscopic morphology of the cells cultured onto HSM PMMA IOLs appears to be normal, thus confirming the noncytotoxicity of the material; (2) fibroblasts grown onto PMMA IOLs are confluent and multilayered; they appear to be in a state of intense activity; the cytoskeletal elements are regularly arranged, and several points of contact at the interface are found; the rare cells present on HSM IOLs do not show at all any of these features; (3) the basic forms of resting and activated platelets are seen onto PMMA IOLs while no sign of activation is observed onto HSM IOLs, and (4) the ultrastructural morphology of monocytes does not differ significantly between the different IOLs. However, other studies are still in progress in order to localize and quantitate the specific receptors responsible for the eventual activation of these cells.