Dense opacification of the optical component of a hydrophilic acrylic intraocular lens: a clinicopathological analysis of 9 explanted lenses.
OBJECTIVE
To report clinical, pathological, histochemical, ultrastructural, and spectrographic analyses of explanted hydrophilic acrylic intraocular lenses (IOLs) obtained from patients who had visual disturbances caused by postoperative opacification of the lens optic.


METHODS
Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA, and Ege University, Alsancak Izmir, Turkey.


METHODS
Nine hydrophilic IOLs (SC60B-OUV, MDR Inc.) were explanted from 9 patients with decreased visual acuity. Most patients became symptomatic approximately 24 months after uneventful phacoemulsification and IOL implantation. Opacification was noted and appeared clinically to be associated with a fine granularity within the substance of the IOL optic. The IOLs were forwarded to the center and examined by gross and light microscopy. Full-thickness cut sections of the optics were stained with 1% alizarin red and the von Kossa method (special stains for calcium). Some were submitted for scanning electron microscopy and energy dispersive x-ray spectroscopy.


RESULTS
Microscopic analyses revealed multiple fine, granular deposits of variable sizes within the lens optics, usually distributed in a line parallel to the anterior and posterior curvatures of the optic, with a clear zone just beneath the optic surface. The deposits stained positive with alizarin red and the von Kossa method. Energy dispersive x-ray spectroscopy of the internal substance of sectioned IOLs demonstrated the presence of calcium within the deposits.


CONCLUSIONS
This is the first clinicopathological report of optic opacification occurring with this hydrophilic acrylic IOL model. Studies of similar cases with this lens should be done to determine the incidence and possible mechanisms of the phenomenon.
Werner
L
L
Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina 29425-5536, USA. wernerl@musc.edu
Apple
D J
DJ
Kaskaloglu
M
M
Pandey
S K
SK
D000180:Acrylic Resins / Q000009:adverse effects*; D000368:Aged; D001672:Biocompatible Materials / Q000009:adverse effects*; D002114:Calcinosis / Q000209:etiology* / Q000473:pathology; D002118:Calcium / Q000032:analysis; D020878:Device Removal; D004577:Electron Probe Microanalysis; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D018918:Phacoemulsification; D011475:Prosthesis Failure
D000180:Acrylic Resins; D001672:Biocompatible Materials; D002118:Calcium