Posters

Opacification of a hydrophylic acrylic lens with hydrophobic surface after air injection in Descemet's stripping automated endothelial keratoplasty in a patient with Fuchs dystrophy

Poster Details

First Author: P. Mojzis CZECH REPUBLIC

Co Author(s):    P. Studeny   L. Werner   D. Pinero              

Abstract Details

Purpose:

We report a case of calcification of a hydrophilic acrylic IOL with hydrophobic surface after air injection during DSAEK in an eye with Fuchs dystrophy.

Setting:

Premium Clinic Teplice, Czech Republic

Methods:

A 71-year old woman with Fuchs endothelial dystrophy underwent phacoemulsification with IOL implantation. At 3 months after surgery, the patient complaining of decreased vision. An uncomplicated DSAEK surgery with an air bubble injection was performed. During the 3 months after DSAEK, the CDVA slowly decreased with the presence of a marked edema. The patient underwent implantation of a new corneal lamela with re-injection of an air bubble in the anterior chamber. 5 months after surgery, the patient attended to our clinic with complaints of blurred vision and IOL presented a glistening-like appearance. An explantation of the opacified IOL was performed.

Results:

A microscopic analysis of the explanted IOL was performed. After gross examination, the unstained specimen was evaluated and photographed under a light microscope. It was then rinsed in distilled water, immersed in 1.0% alizarin red solution for 10 minutes, rinsed again in distilled water, and re-examined under light microscopy. Gross laboratory analyses showed an overall round area of mild white discoloration that was present in the central part of the optic. Light microscopy revealed the presence of thin granular deposits in the area of gross mild white discoloration, distributed in an overall round pattern. The granules were present on the anterior surface/subsurface of the IOL and stained positive for calcium (alizarin red stain).

Conclusions:

The opacification of hydrophilic acrylic IOLs is a complication that may occur after uneventful endothelial keratoplasty, especially when rebubbling is necessary. In cases with the potential requirement of posterior endothelial keratoplasty, such as in Fuchs dystrophy, hydrophilic acrylic IOLs should be avoided.

Financial Disclosure:

NONE