Classification of pattern in opacified intraocular lenses: a structural analysis

Session Details

Session Title: Cataract Surgery Complications: IOL Dislocation and Opacification

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

Paper Time: 15:16

Venue: Room 3.6

First Author: : M.Mackert GERMANY

Co Author(s): :    D. Muth   S. Priglinger   A. Wolf              

Abstract Details

Purpose:

Intraocular lens (IOL) opacification is a rare condition, but may cause severe visual affections. The aim of this study was to investigate a possible pattern and differentiate characteristics of IOL opacifications in explanted IOLs.

Setting:

This single-centre, retrospective, observational study was performed at the Ludwig-Maximilians-University eye hospital, Munich, Germany.

Methods:

Seventeen IOLs of 16 patients presenting with deteriorated vision or reduced contrast sensitivity due to IOL opacification were examined after extraction. For analysis, the explanted IOLs were macroscopically photo documented in a standardised manner. The opacifications were then microscopically analysed using a new high precision digital microscope (VHX-5000, Keyence corp.). The images were taken according to a pre-defined scheme, including a three-dimensional and a high dynamic range (HDR) image at 30x, 100x and 500x magnification. All opacifications were screened and analysed for topographic as well as structural repeating patterns.

Results:

Of the 17 explants 16 were identifiable: 15 acrylic single-piece IOLs (Lentis LS-312Y, LS-313Y, LS-311Y, L-312) and one hydrophilic acrylic 3-piece IOL (Euromaxx Ali-313Y). In all lenses only the anterior surface presented opacifications. Sixteen IOLs showed granular deposits and one IOL showed central crust-like changes. Fourteen IOLs had a central oval-shaped less opacified deepened defect. Seven IOLs had a small round zone without any opacification, located in the middle periphery of the IOL surface, showing a prominent rim with accumulated deposits.

Conclusions:

In our series, most of the explanted IOLs were hydrophilic copolymers with a hydrophobic surface. While some similarities of the opacification patterns exist (referred to as typical opacifications), some lenses showed different opacifications regarding type, distribution and pattern of opacifications. In the analysed lenses a fine granular deposit was predominant. Interestingly, a small round clear zone within the opacities, surrounded by accumulated deposits was found in all “typical” opacifications.

Financial Disclosure:

NONE