IOL opacification after posterior lamellar keratoplasty: a material analysis with special reference to optical quality assessment

Session Details

Session Title: Cataract Surgery Complications: IOL Dislocation and Opacification

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:00

Paper Time: 15:04

Venue: Room 3.6

First Author: : R.Khoramnia GERMANY

Co Author(s): :    T. Tandogan   B. Giers   S. Sel   G. Auffarth           

Abstract Details

Purpose:

Laboratory analysis and optical quality assessment of explanted hydrophilic intraocular lenses (IOLs) with clinically significant opacification after posterior lamellar keratoplasty (DMEK and DSAEK).

Setting:

David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Center, Department of Ophthalmology, University of Heidelberg, Germany

Methods:

13 opacified IOLs (8 different IOL models from 4 different manufacturers) after posterior lamellar keratoplasty, 8 after descemet stripping automated endothelial keratoplasty (DSAEK), 3 after descemet membrane endothelial keratoplasty (DMEK) and 2 after both DSAEK and DMEK were analysed in our laboratory. Analyses included optical bench assessment for optical quality, light microscopy, scanning electron microscopy (SEM) and energy dispersive X-Ray spectroscopy (EDS).

Results:

In all IOLs the opacification was caused by a thin layer of calciumphosphate that had accumulated underneath the anterior optical surface of the IOLs in the area spared by the pupil/anterior capsulorhexis. The calcifications lead to a significant deterioration of the modulation transfer function across all spatial frequencies of the affected IOLs.

Conclusions:

The instillation of exogenous material such as air or gas into the anterior chamber seems to increase the risk for hydrophilic IOL opacification irrespective of the manufacturer or the lens material.

Financial Disclosure:

NONE