title: Clinicopathologic correlation of capsulorhexis phimosis with anterior flexing of single-piece hydrophilic acrylic intraocular lens haptics.
abstract: We describe 2 cases in which patients with 4-looped single-piece hydrophilic acrylic intraocular lenses (IOLs) exhibited postoperative complications including capsulorhexis phimosis, decentration, tilt, hyperopic shift, and luxation leading to explantation of the IOL-capsular bag complex. The excessive capsule fibrosis led to anterior flexing of the IOL haptics in both cases, even in the presence of a capsular tension ring (CTR). Histopathological analyses revealed a thick fibrocellular tissue attached to the inner surface of the anterior capsules, corresponding to the anterior capsule opacification and folds. An amorphous substance was observed on the outer surface of the anterior capsule in the case with a CTR, suggesting pseudoexfoliation material. These and similar cases raise concerns about the postoperative behavior of highly flexible IOLs in the presence of excessive capsular bag fibrosis.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: John A Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Zaugg
authors.forename: Liliana
authors.initials: L
authors.lastname: Werner
authors.forename: Tobias
authors.initials: T
authors.lastname: Neuhann
authors.forename: Michael
authors.initials: M
authors.lastname: Burrow
authors.forename: Don
authors.initials: D
authors.lastname: Davis
authors.forename: Nick
authors.initials: N
authors.lastname: Mamalis
authors.forename: Manfred
authors.initials: M
authors.lastname: Tetz
mesh_terms: D000180:Acrylic Resins; D019923:Capsulorhexis; D020878:Device Removal; D005260:Female; D005355:Fibrosis; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008679:Metaplasia; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011475:Prosthesis Failure
chemical_list: D000180:Acrylic Resins