Opacification of two hydrophilic acrylic intraocular lenses 3 months after implantation.
OBJECTIVE
To report clinical, pathologic, histochemical, ultrastructural, and spectrographic analyses of explanted hydrophilic acrylic intraocular lenses (IOLs) obtained from two patients who had early visual disturbances caused by postoperative opacification of the lens optic.


METHODS
Two hydrophilic IOLs were explanted from patients with decreased visual acuity. The patients became symptomatic 3 months after uneventful phacoemulsification and lens implantation. IOL optic opacification was associated with a fine granularity within the substance of the lens optic. The IOLs were examined by gross and light microscopy. Full-thickness cut sections of the optics were stained with 1% alizarin red (a special stain for calcium). Some sections were submitted for scanning electron microscopy and energy dispersive x-ray spectroscopy.


RESULTS
Microscopic analyses revealed the presence of multiple fine, granular deposits of variable sizes within the optics of the lenses distributed in a line parallel to the anterior and posterior curvatures of the optic, with a clear zone just beneath the optics' surface. Extension of the opacification into the haptics of the IOLs could also be observed. The deposits stained positive with alizarin red. Energy dispersive x-ray spectroscopy of the internal substance of the IOLs also demonstrated the presence of calcium within the deposits.


CONCLUSIONS
This is the first clinicopathologic report of optic and haptic opacification occurring with this hydrophilic acrylic IOL model only 3 months postoperatively. Further studies on other similar cases with this lens should be done to determine the incidence and possible mechanisms of this phenomenon.
Macky
Tamer A
TA
Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City 84132, USA.
Werner
Liliana
L
Soliman
Mahmoud M
MM
Pandey
Suresh K
SK
Izak
Andrea M
AM
Apple
David J
DJ
D000180:Acrylic Resins / Q000009:adverse effects*; D000368:Aged; D000880:Anthraquinones; D002114:Calcinosis / Q000209:etiology* / Q000473:pathology; D002118:Calcium / Q000032:analysis; D020878:Device Removal; D004577:Electron Probe Microanalysis; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D018918:Phacoemulsification; D011475:Prosthesis Failure; D013194:Staining and Labeling / Q000379:methods
D000180:Acrylic Resins; D000880:Anthraquinones; C010078:alizarin; D002118:Calcium