[Secondary opacification of hydrophilic acrylic intraocular lenses: report of two cases]

Abstract

Purpose: To describe two cases of secondary opacification of hydrophilic acrylic IOLs after vitreoretinal surgery.

Methods: Analysis of IOL deposits with anterior segment optical coherence tomography (OCT Visante(®)) and high-frequency ultrasound biomicroscopy (CineScan HF, Quantel Medical(®)) was carried out preoperatively. The explanted IOLs were analyzed with optical and electron microscopy, and energy dispersive spectrometry (EDS).

Results: In both patients, the deposits were located on the surface and within the implant and were composed of calcium phosphate crystals. Vitreoretinal surgery performed a few months prior to the secondary opacification was identified as a risk factor.

Conclusion: When a patient presents with a secondary opacification of the IOL involving the visual axis, explantation is sometimes necessary, fortunately with typically good functional recovery in the postoperative period. While this complication is rare and the exact pathophysiology poorly understood, it must be considered in a pseudophakic patient with an unexplained decrease in visual acuity who has undergone more than one intraocular procedure.

Keywords: Calcification; Implant intraoculaire; Intraocular lenses; Opacification secondaire; Secondary opacification.