title: Opacification of AcriFlex 50CSE hydrophilic acrylic intraocular lenses.
abstract: OBJECTIVE
  To determine the prevalence of and risk factors for AcriFlex 50CSE hydrophilic acrylic intraocular lens (IOL) opacification approximately 3 years after implantation.
  
  
  METHODS
  Selayang Hospital, Selangor, Malaysia.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Patients who had AcriFlex 50CSE IOL implantation in 2005 and 2006 were identified from operating logbooks and recalled via telephone and letters. Opaque IOLs were explanted and sent for scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS).
  
  
  RESULTS
  The review showed that 18 patients had died and 67 had declined examination or could not be contacted, leaving 239 eyes for evaluation. The age of the patients ranged from 25 to 85 years. Of the patients, 83 (34.7%) were Malay, 127 (53.1%) Chinese, and 29 (12.1%) East Indian. The male:female ratio was 1:1. Fourteen eyes of 13 patients (5.4%) had IOL opacification; 1 had bilateral opacification. Five eyes had fine deposits, and 9 eyes had dense opaque deposits. Seven opaque IOLs required explantation. There was no correlation between age (P=.645), sex (P=.319), or race (P=.860) and IOL opacification. Pearson chi-square analysis showed a strong association between diabetes mellitus and IOL opacification (P=.019). Nine (69.2%) of the 13 patients with opacification had diabetes. Scanning electron microscopy and EDS showed calcium and phosphate deposits on the optic surface and intralenticularly near the anterior surface of the optic.
  
  
  CONCLUSIONS
  Results indicate that diabetes mellitus is a risk factor for AcriFlex hydrophilic acrylic IOL opacification. In some cases, opacification affected vision, necessitating explantation. The pathophysiology of this complication is unknown.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Penang Hospital, Penang, Malaysia. akelim@yahoo.com
authors.forename: Andrew Keat Eu
authors.initials: AK
authors.lastname: Lim
authors.forename: Pik Pin
authors.initials: PP
authors.lastname: Goh
authors.forename: Ramlee
authors.initials: R
authors.lastname: Azura
authors.forename: Ismail
authors.initials: I
authors.lastname: Mariam
mesh_terms: D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D020878:Device Removal; D005260:Female; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D007910:Lenses, Intraocular; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011183:Postoperative Complications; D015995:Prevalence; D011475:Prosthesis Failure; D012086:Reoperation; D012307:Risk Factors; D013052:Spectrometry, X-Ray Emission
chemical_list: D000180:Acrylic Resins