title: Calcification of Hydrophilic Acrylic Intraocular Lenses With a Hydrophobic Surface: Laboratory Analysis of 6 Cases.
abstract: OBJECTIVE
  To investigate the nature and characteristic features of deposits causing opacification of intraocular lenses (IOLs) based on the examination of clinical findings using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDX) analysis.
  
  
  METHODS
  Retrospective, observational case series.
  
  
  METHODS
  This is a multicenter study of 6 hydrophilic acrylic IOLs (Lentis LS-502-1; Oculentis GmbH, Berlin, Germany) with a hydrophobic surface that were explanted from 5 patients because of opacification. Three patients had an uncomplicated phacoemulsification. One patient underwent combined phacoemulsification and pars plana vitrectomy for retinal detachment and later silicone oil endotamponade owing to redetachment. The last patient had a pars plana vitrectomy and silicone oil instillation combined with phacoemulsification for tractive retinal detachment and diabetic retinopathy. The explanted lenses were submitted to our laboratory and were examined by SEM and EDX in order to identify the morphologic features and the composition of the deposits.
  
  
  RESULTS
  SEM and EDX analyses confirmed the presence of calcific deposits in the interior of the opacified hydrophilic IOLs, with a pattern showing the formation of lumps on the surface. The lumps were due to subsurface formation of calcium phosphate crystalline deposits. The crystallite clusters seemed to diffuse from the IOL interior to the surface.
  
  
  CONCLUSIONS
  We demonstrated the calcification pattern of the hydrophilic IOL (Lentis LS-502-1) with a hydrophobic surface. Although hydrophilic acrylic lenses have a hydrophobic surface, the development of calcification is a possible threat initiating from the hydrophilic subsurface of the IOLs.
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece. Electronic address: s.gartag@med.upatras.gr.
authors.forename: Sotirios P
authors.initials: SP
authors.lastname: Gartaganis
authors.affiliation: Department of Ophthalmology, University Hospital of Regensburg, Regensburg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Prahs
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece.
authors.forename: Eftichia D
authors.initials: ED
authors.lastname: Lazari
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece.
authors.forename: Panos S
authors.initials: PS
authors.lastname: Gartaganis
authors.affiliation: Department of Ophthalmology, University Hospital of Regensburg, Regensburg, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Helbig
authors.affiliation: Department of Chemical Engineering, Laboratory of Inorganic and Analytical Chemistry, University of Patras, and FORTH-ICEHT, Patras, Greece.
authors.forename: Petros G
authors.initials: PG
authors.lastname: Koutsoukos
mesh_terms: D000180:Acrylic Resins; D000368:Aged; D002114:Calcinosis / Q000209:etiology*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D007910:Lenses, Intraocular; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013052:Spectrometry, X-Ray Emission
chemical_list: D000180:Acrylic Resins