Widespread opacification of a hydrophilic/hydrophobic intraocular lens

Session Details

Session Title: Cataract Surgery Complications: IOL Dislocation and Opacification

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

Paper Time: 15:22

Venue: Room 3.6

First Author: : J.Costa PORTUGAL

Co Author(s): :    P. Ramos   M. Marques   J. Henriques   J. Povoa   C. Lobo   J. Murta     

Abstract Details

Purpose:

To determine the prevalence and risk factors leading to opacification of the LS-502-1 IOL (Oculentis®), a hydrophobic intraocular lens (IOL) with a hydrophobic coating.

Setting:

Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal

Methods:

Cross-sectional study including patients submitted to cataract surgery between January 2010 and March 2012, with implantation of the LS-502-1 IOL. Past medical history and surgery details, including IOL data, were registered and a complete ophthalmologic evaluation, that included best-corrected visual acuity, slit-lamp examination and fundoscopy, was performed. Slit-lamp biomicrography was obtained whenever IOL opacification was present. The explanted lenses were sent to the Ophthalmic Explants Biobank (VISSUM®, Spain), in order to perform scanning electron microscopy. Part of the IOLs was also sent to the John A. Moran Eye Center (University of Utah, USA) for microscopic and immunohistochemical analysis.

Results:

169 eyes (154 patients) were included, mean age 78.5±7.9 years. The average follow-up after IOL implantation was 65.6±10.0 months. Opacification was present in 53.3% of the IOLs (n=90). Demographic data and comorbidities (general and ophthalmologic) were similar in both groups. The opacification rate showed a significant variability depending on the IOL’s serial number: IOL opacification was 6.0 times greater in IOLs with serial number beginning with 20000300000 than in the remaining lenses. As of November 2016, 32.2% (n=29) of the opacified IOLs were explanted. Laboratory analysis showed calcified granules on the surface and within the IOL polymer.

Conclusions:

The opacification rate of the LS-502-1 IOL was 53.3%, which is, to the best of our knowledge, the highest ever described for any IOL design. Our results suggest that this occurrence is secondary to primary calcification of the IOL, possibly related to the lens’ manufacturing and/or storage procedures. Every ophthalmologist should be aware of this late complication, not only in order to allow a timely diagnosis and treatment, but also due to the foreseeable medico-legal consequences.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a competing company