Opacification of hydrophilic intraocular lenses after pars plana vitrectomy with subsequent gas installation

Session Details

Session Title: IOL Dislocation & Opacification

Session Date/Time: Tuesday 25/09/2018 | 14:00-16:00

Paper Time: 15:36

Venue: Room A3, Podium 1

First Author: : R.Khoramnia GERMANY

Co Author(s): :    T. Yildirim   S. Bopp   H. Son   G. Labuz   P. Merz   G. Auffarth     

Abstract Details

Purpose:

Currently, the only treatment option for patients with IOL opacification is IOL exchange, which may pose the risk of further complications.Explanted hydrophilic intraocular lenses (IOLs) with clinically significant opacification after pars plana vitrectomy (PPV) were assessed for material change and optical quality, in an in-vitro laboratory study.

Setting:

The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, Department of Ophthalmology, University of Heidelberg, Germany

Methods:

10 opacified IOLs after PPV with intraocular gas injection were analyzed in our laboratory. Analyses included evaluation of patients’ medical history, optical quality assessment, light microscopy, histological staining, scanning electron microscopy and energy dispersive X-Ray spectroscopy.

Results:

In all 10 IOLs a thin layer of calcium phosphate that had accumulated underneath either the anterior or posterior optical surface in a central circular area of the IOL optic caused the opacification. The calcifications lead to deterioration of the modulation transfer function (MTF) across all spatial frequencies.

Conclusions:

PPV with instillation of gas into a pseudophakic eye with an acrylic hydrophilic lens seems to increase the risk for secondary calcification irrespective of the manufacturer. In these cases, IOL exchange is the only treatment option available. Since IOL exchange is associated with a high intraoperative complication rate, our results suggest a recommendation to avoid the implantation of hydrophilic acrylic IOLs in patients who will likely require procedures where there could be direct contact of the IOL with gas or air.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a competing company, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a competing company, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a competing company