title: Opacification of intraocular lenses implanted during infancy: a clinicopathologic study of 4 explanted intraocular lenses.
abstract: OBJECTIVE
  To report the clinicopathologic features of 4 opacified, single-piece, hydrophilic, acrylic intraocular lenses (IOLs) explanted from children who had undergone IOL implantation during infancy.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Four IOLs explanted from 4 eyes of 3 children for visually significant opacification were included in the study.
  
  
  METHODS
  The clinical details of each case were obtained to look for possible risk factors for IOL opacification. The explanted IOLs were subjected to gross examination, staining by alizarin red 1% for calcium, scanning electron microscopy, and energy-dispersive x-ray spectroscopy (EDS). Levels of calcium and phosphorous were analyzed in the serum of all cases and in the aqueous humor of 1 case.
  
  
  METHODS
  Morphologic features and composition of deposits.
  
  
  RESULTS
  Two cases had congenital cataract while one case was after bilateral lens sparing vitrectomy for retinopathy of prematurity. All underwent surgery during infancy with implantation of an IOL. The IOLs were explanted 8 months after surgery from 4 eyes of 3 children at the age of 17, 25, and 26. All the children received a single-piece hydrophilic acrylic IOL. The IOLs were in situ for an average duration of 13.86 months. The deposits were in the shape of a bicycle wheel on 3 IOLs and looked like fish eggs on 1 IOL. All deposits stained bright orange with alizarin red. On EDS, the deposits were found to be composed of calcium, phosphate, and silicone.
  
  
  CONCLUSIONS
  The morphologic features and composition of IOL deposits in 2 cases were similar to those of earlier reports in adults. The hydrophilic nature of the IOL material, sulcus implantation, and postoperative inflammation may be possible risk factors for opacification.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors.affiliation: The David Brown Children's Eye Care Center, L.V. Prasad Eye Institute, Vijayawada, India.
authors.forename: Niranjan K
authors.initials: NK
authors.lastname: Pehere
authors.forename: Sreedhar
authors.initials: S
authors.lastname: Bojja
authors.forename: Geeta K
authors.initials: GK
authors.lastname: Vemuganti
authors.forename: Pravin K
authors.initials: PK
authors.lastname: Vaddavalli
authors.forename: Monica
authors.initials: M
authors.lastname: Samant
authors.forename: Subhadra
authors.initials: S
authors.lastname: Jalali
authors.forename: Manjushree
authors.initials: M
authors.lastname: Bhate
mesh_terms: D000180:Acrylic Resins; D001082:Aqueous Humor / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002386:Cataract / Q000151:congenital; D002387:Cataract Extraction; D020878:Device Removal; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008855:Microscopy, Electron, Scanning; D010758:Phosphorus / Q000097:blood; D011475:Prosthesis Failure; D012178:Retinopathy of Prematurity / Q000209:etiology; D013052:Spectrometry, X-Ray Emission
chemical_list: D000180:Acrylic Resins; D010758:Phosphorus; D002118:Calcium