Interlenticular opacification: clinicopathological correlation of a complication of posterior chamber piggyback intraocular lenses.
OBJECTIVE
To present a clinicopathological correlation of 2 pairs of piggyback posterior chamber intraocular lenses (PC IOLs) explanted because of opacification between the lens optics.


METHODS
Gayton Health Center, Eyesight Associates of Middle Georgia, Warner Robins, Georgia, and Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.


METHODS
Two pairs of piggyback AcrySof lenses were explanted from 2 patients with significant visual loss related to opacification between the optics. They were submitted for pathological analysis. Gross and histopathological examinations were performed, and photomicroscopy was used to document the results.


RESULTS
Gross examination showed accumulation of a membrane-like white material between the lenses. Histopathological examination revealed that the tissue consisted of retained/proliferative lens epithelial cells (bladder cells or pearls) mixed with lens cortical material.


CONCLUSIONS
Piggyback PC IOLs were explanted in 2 cases because of a newly described complication, interlenticular opacification. Three surgical means may help prevent this complication: meticulous cortical cleanup, especially in the equatorial region; creation of a relatively large continuous curvilinear capsulorhexis to sequester retained cells peripheral to the IOL optic within the equatorial fornix; insertion of the posterior IOL in the capsular bag and the anterior IOL in the ciliary sulcus to isolate retained cells from the interlenticular space.
Gayton
J L
JL
Gayton Health Center, Eyesight Associates of Middle Georgia, Warner Robins, Georgia, USA.
Apple
D J
DJ
Peng
Q
Q
Visessook
N
N
Sanders
V
V
Werner
L
L
Pandey
S K
SK
Escobar-Gomez
M
M
Hoddinott
D S
DS
Van Der Karr
M
M
D000180:Acrylic Resins; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000209:etiology* / Q000473:pathology; D002455:Cell Division; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000473:pathology*; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D018918:Phacoemulsification; D012086:Reoperation; D014792:Visual Acuity
D000180:Acrylic Resins