Effect of intraocular air or gas injection on hydrophilic intraocular lens material

Session Details

Session Title: Presented Poster Session: IOL Opacification

Venue: Poster Village: Pod 1

First Author: : R.Khoramnia GERMANY

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

Abstract Details

Purpose:

Several surgical procedures include intraocular gas or air injection. In pseudophakic eyes undergoing such a surgery there is a risk of IOL opacification due to direct contact of lens material with gas or air. We analyzed explanted hydrophilic intraocular lenses (IOLs) that had shown opacification after such procedures.

Setting:

David J Apple International Laboratory, University Eye Clinic Heidelberg

Methods:

28 lenses that were explanted after IOL opacification due to intraocular use of gas or air were submitted to the David J. Apple International Laboratory for Ocular Pathology. 9 eyes had undergone pars plana vitrectomy (PpV), 13 eyes descemet stripping endothelial keratoplasty (DSAEK) or descemet membrane endothelial keratoplasty (DMEK). After optical quality assessment the lenses were further analyzed using light microscopy (staining with von Kossa and Alizarin red), scanning electron microscopy and energy dispersive X-Ray spectroscopy.

Results:

Accumulation of calciumphosphate underneath the optical surface of the IOL was the reason for opacification in all analyzed cases. In opacified IOLs after posterior lamellar keratoplasty, a thin layer of calciumphosphate had accumulated underneath the anterior optical surface of the IOL in the area spared by the pupil/anterior capsulorhexis. In 8 of 9 opacified IOLs after PpV, calciumphosphate deposits were also found just beneath the anterior optical surface of the IOL. We found different degrees of calcification that lead to a dramatic decrease of optical quality in some of the cases.

Conclusions:

Hydrophilic IOL material has a higher risk of opacification when exogenous material such as air or gas is injected into the eye. In cases which will likely require procedures with intraocular gas or air installation later on it is recommended to avoid the use of hydrophilic acrylic IOLs.

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