Localized Opacification of Hydrophilic Acrylic IOLs After Procedures Using Intracameral Injection of Air/Gas

Monday, April 28, 2014: 3:16 PM
Room 151A (Boston Convention and Exhibition Center)
Liliana Werner, MD, PhD, John A. Moran Eye Center, Salt Lake City, UT, USA
Garth A. Wilbanks, MD, Eastern maine eye associates, Bangor, ME, USA
Carla P. Nieuwendaal, MD, Academic Medical Center, Amsterdam, Netherlands
Anish Dhital, MRCOphth, King's College Hospital, London, United Kingdom
Aaron N. Waite, MD, University of Tennessee, Memphis, TN, USA
Gerald Schmidinger, MD, Medical University of Vienna, Vienna, Austria
Nick Mamalis, MD, Moran Eye Ctr/Univ of Utah, Salt Lake City, Utah, USA

Narrative Responses:

Purpose
To describe clinicopathological findings in a series of cases of intraocular lens (IOL) opacification after procedures involving intracameral injections of air/gas.

Methods
Six hydrophilic acrylic IOLs were explanted after DSEK/DSAEK because of a localized central optic opacification associated with significant decrease in visual acuity and complaints of foggy vision. The lenses underwent pathological and histochemical evaluation. Light scattering measurements were also performed on the surface of one of the explants.

Results
The 6 explanted lenses were represented by 5 different hydrophilic acrylic designs, from 3 manufacturers. Gross and light microscopy showed that granular deposits were densely distributed in an overall round pattern within the margins of the capsulorrhexis or the pupil, on the anterior surface/subsurface of the IOLs. The granules stained positive for calcium (alizarin red and von Kossa method). Light scattering on the anterior optic surface was very high (228 CCT versus 13 CCT on a control lens).

Conclusion
We describe a localized pattern of calcification on the anterior surface/subsurface of various hydrophilic acrylic IOLs. Surgeons should be aware of this phenomenon following DSEK/DSAEK procedures in pseudophakic patients with hydrophilic acrylic lenses.