title: Calcification of a hydrophilic acrylic intraocular lens after Descemet-stripping endothelial keratoplasty: case report and laboratory analyses.
abstract: We describe the case of an 83-year-old woman who had uneventful phacoemulsification with implantation of a tripod hydrophilic acrylic intraocular lens (IOL). Because of postoperative corneal decompensation, 2 Descemet-stripping endothelial keratoplasty (DSEK) procedures were performed within 2 years. After the second procedure, the graft was not well attached, requiring an intracameral injection of air on day 3. Approximately 9 months later, opacification was observed on the anterior surface of the IOL, with a significant decrease in visual acuity. The IOL was explanted within the capsular bag. Laboratory analyses revealed granular deposits densely distributed in a round pattern within the margins of the capsulorhexis. Granules were located at the anterior surface/subsurface of the IOL and stained positive for calcium (alizarin red and von Kossa method). Scheimpflug photography revealed high levels of light scattering from the opacified area. Surgeons should be aware of possible localized calcification following DSEK procedures in pseudophakic patients with hydrophilic acrylic IOLs.
authors.affiliation: John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Fellman
authors.forename: Liliana
authors.initials: L
authors.lastname: Werner
authors.forename: Erica T
authors.initials: ET
authors.lastname: Liu
authors.forename: Shannon
authors.initials: S
authors.lastname: Stallings
authors.forename: Anne M
authors.initials: AM
authors.lastname: Floyd
authors.forename: Ivanka J E
authors.initials: IJ
authors.lastname: van der Meulen
authors.forename: Ruth
authors.initials: R
authors.lastname: Lapid-Gortzak
authors.forename: Carla P
authors.initials: CP
authors.lastname: Nieuwendaal
mesh_terms: D000180:Acrylic Resins; D000369:Aged, 80 and over; D002114:Calcinosis / Q000209:etiology* / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D057111:Descemet Stripping Endothelial Keratoplasty / Q000009:adverse effects*; D020878:Device Removal; D005260:Female; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008027:Light; D018918:Phacoemulsification; D011475:Prosthesis Failure / Q000209:etiology*; D012086:Reoperation; D012542:Scattering, Radiation; D014792:Visual Acuity
chemical_list: D000180:Acrylic Resins; D002118:Calcium