Calcification in hydrophilic intraocular lenses associated with injection of intraocular gas.
OBJECTIVE
To report a distinct type of calcification in hydrophilic intraocular lenses in complicated, traumatized eyes with a history of intraocular gas use.


METHODS
Observational case series.


METHODS
Three cases of hydrophilic intraocular lens (IOL) opacification confined to the pupillary area are reported from clinical practice in London, UK. Clinical details and analysis of the explanted intraocular lenses are provided with environmental scanning electron microscopy images and x-ray energy-dispersive spectroscopy results.


RESULTS
All cases were associated with use of intraocular gas in complicated traumatized eyes, and had central areas of IOL opacification over the pupillary zone, confined to the anterior surface of the IOL. Analysis of the lenses showed the opacified areas to be composed of calcium and phosphate.


CONCLUSIONS
The areas of opacification in all 3 hydrophilic IOLs were attributable to calcification. We postulate that intraocular gas use and the altered blood-aqueous barrier of these complicated traumatized eyes co-act to trigger secondary IOL calcification. Further experimental testing is needed to confirm this clinical association.
St Thomas' Hospital, London, United Kingdom. anishdhital@gmail.com
Anish
A
Dhital
David J
DJ
Spalton
Saurabh
S
Goyal
Liliana
L
Werner
D000368:Aged; D002114:Calcinosis / Q000139:chemically induced* / Q000473:pathology; D020878:Device Removal; D058450:Endotamponade; D005466:Fluorocarbons / Q000008:administration & dosage / Q000009:adverse effects*; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D056965:Injections, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011475:Prosthesis Failure; D012163:Retinal Detachment / Q000601:surgery; D013052:Spectrometry, X-Ray Emission; D013459:Sulfur Hexafluoride / Q000008:administration & dosage / Q000009:adverse effects*; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride