Calcification of hydrophilic acrylic intraocular lenses with a hydrophobic surface following uneventful Descemet's stripping automated endothelial keratoplasty

Session Details

Session Title: Cataract Surgery Complications: IOL Dislocation and Opacification

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

Paper Time: 15:10

Venue: Room 3.6

First Author: : U.Kolodziejska POLAND

Co Author(s): :    T. Gałecki   M. Udziela   E. Mendyk   A. Gumieniczek   J. Szaflik        

Abstract Details

Purpose:

To describe clinical and laboratory findings in series of cases of intraocular lens’ (IOL) opacification after Descemet’s stripping automated endothelial keratoplasty (DSAEK)

Setting:

Department of Ophthalmology Medical University of Warsaw, Poland Analytical Laboratory. Faculty of Chemistry, Maria Curie- Sklodowska University. 3, Maria Curie-Skłodowska Sq., 20-031 Lublin, Poland Department of Medicinal Chemistry, Medical University of Lublin, 20-090 Lublin, Jaczewskiego 4, Poland

Methods:

Retrospective, comparative, observational case series. A total number of 78 patients underwent uneventful DSAEK with simultaneus cataract phacoemulsification and PCIOL implantation: in 35 cases Alcon SA60AT hydrophobic acrylic, in 31 cases Lentis LS-302-Y, in 12 cases Lentis L-302-1 - both hydrophilic acrylic with the hydrophobic surface manufactured by Oculentis GmbH. 36 cases of IOL calcification were reported (0-Alcon SA60AT, 25-Lentis LS-302-Y, 11-Lentis L-302-1). Laboratory analysis of 2 explanted and 1 new IOL were performed with optical microscopy, optical profilometry, and scanning electron microscopy (SEM) with Energy Dispersive X-Ray Analysis (EDX) method.

Results:

Opacification rate was 0% for Alcon SA60AT, 81% for Lentis LS-302-Y and 92% for Lentis L-302-1. In all cases, superficial IOL opacification consisted of fine granular areas confined to the pupillary zone were diagnosed. Texture imaging indicates that the anterior surface of affected IOL is significantly rougher than the posterior surface and the surface of new IOL. Surface roughness Ra=0,88µm vs Ra=0.0049µm vs Ra=0.0045µm. Formation of lumps starts inside IOL’s material (maximal depth=35µm) with the highest concentration just under the hydrophobic membrane. SEM/EDX analyses confirmed the presence of granules composed of calcium and phosphorus.

Conclusions:

Hydrophobic surface of hydrophilic IOL is not the protection from occurrence of IOL calcification. The deformation of the polymer’s surface is secondary to growth of crystal granules in subsurface, hydrophilic area. Because of increased risk of opacification after DSAEK, hydrophilic acrylic intraocular lenses with hydrophobic surface should be avoided in patients with endothelial disorders.

Financial Disclosure:

NONE