The study IOL is a modification of a previous design, incorporating haptic perforations between the peripheral rings. By maintaining an open capsular bag and enhancing endocapsular inflow of aqueous, this modified design appears to prevent capsular bag opacification.

No author has a financial or proprietary interest in any material or method mentioned.

We would like to call attention to a phenomenon of calcification of various hydrophilic acrylic intraocular lenses (IOLs) following procedures using intracameral injections of gas. Calcification is localized to the anterior surface/subsurface of the IOL and within the pupillary area. Poor quality of vision through the opacification has required IOL exchange in several cases. The explanted IOLs were analyzed by us and others.Saeed et al. 1 described a case in which sulphur hexafluoride and later perfluoropropane gas was used intracamerally to manage large iatrogenic Descemet membrane detachments observed during cataract surgery. A few weeks later, a fine haze was observed under the anterior surface of the hydrophilic acrylic IOL. Details on the aspect or nature of the IOL opacification were, however, not available in the report. Three cases of calcification of hydrophilic acrylic IOLs associated with intraocular injection of gas were recently compiled by Dhital et al. 2 The explanted IOL from one of those cases was analyzed in our laboratory. The patient, who had a history of Fuchs endothelial corneal dystrophy, had phacoemulsification with implantation of a hydrophilic acrylic IOL combined with Descemet-stripping automated endothelial keratoplasty (DSAEK) in February 2007, with subsequent intracameral injections of air and gas. The DSAEK was repeated in August 2007 with a complete gas fill of the anterior chamber. Approximately 1 month later, a central circular area of IOL opacification was noted. In the other 2 cases, IOL opacification was observed after intracameral injection of gas to control hypotony following trabeculectomy and after vitrectomy with cryotherapy and intravitreous injection of gas in an eye with a history of blunt trauma, respectively. The 3 cases by Dhital et al. 2 shared a distinctive pattern of opacification limited to the anterior surface and/or subsurface of the IOL and defined by the pupillary margin. The calcific nature of the deposits observed within the area of opacification was confirmed by histochemical staining and scanning electron microscopy coupled with energy-dispersive x-ray spectroscopy. 2 Our laboratory has recently analyzed another similar case of localized IOL calcification following DSAEK. The patient had Fuchs dystrophy and had had uneventful phacoemulsification with hydrophilic acrylic IOL implantation in June 2010. Descemetstripping automated endothelial keratoplasty with intracameral injections of air was performed in October 2010. Two months later, the patient complained of "foggy" vision. Opacification of the anterior surface of the IOL within the pupillary area was observed. Figure 1. Case of localized hydrophilic acrylic IOL opacification after DSAEK, leading to explantation. A: Clinical photograph taken after pupil dilation. The arrows delineate the area of opacification, which is denser in the upper right quadrant. B: Gross photograph of the IOL, which was bisected for explantation. C: Light photomicrograph of the explanted IOL showing the presence of deposits o...

In this rabbit study, the new hydrophobic acrylic material was biocompatible. The barrier step incorporated to the optic-haptic junctions has the potential to enhance PCO prevention.

The study IOL maintained an expanded capsular bag secondary to the large size of the haptic elements, which appears to prevent capsular bag opacification.

Purpose:To compare differences in visual acuity, contrast sensitivity, complications, and higher-order ocular aberrations (HOAs) in eyes with stable myopia undergoing either photo-refractive keratectomy (PRK) or thin-flap laser in situ keratomileusis (LASIK) (intended flap thickness of 90 μm) using the VISX Star S4 CustomVue excimer laser and the IntraLase FS60 femtosecond laser at 1, 3, and 6 months postoperatively.Methods:In this prospective, masked, and randomized pilot study, refractive surgery was performed contralaterally on 52 eyes: 26 with PRK and 26 with thin-flap LASIK. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and complications.Results:At 6 months, mean values for UDVA (logMAR) were −0.043 ± 0.668 and −0.061 ± 0.099 in the PRK and thin-flap LASIK groups, respectively (n = 25, P = 0.466). UDVA of 20/20 or better was achieved in 96% of eyes undergoing PRK and 92% of eyes undergoing thin-flap LASIK, whereas 20/15 vision or better was achieved in 73% of eyes undergoing PRK and 72% of eyes undergoing thin-flap LASIK (P > 0.600). Significant differences were not found between treatment groups in contrast sensitivity (P ≥ 0.156) or CDVA (P = 0.800) at postoperative 6 months. Types of complications differed between groups, notably 35% of eyes in the thin-flap LASIK group experiencing complications, including microstriae and 2 flap tears.Conclusion:Under well-controlled surgical conditions, PRK and thin-flap LASIK refractive surgeries achieve similar results in visual acuity, contrast sensitivity, and induction of HOAs, with differences in experienced complications.

Anterior segment OCT may be helpful in assessing the presence, location, and density of intraoptic changes, avoiding a misdiagnosis of IOL opacification and the performance of unnecessary procedures, such as posterior capsulotomy or vitrectomy.

PurposeTo describe the presentation and clinical course of eyes with a history of radial keratotomy (RK) and varying degrees of endothelial degeneration.MethodsRetrospective case series were used.ResultsThirteen eyes (seven patients) were identified with clinical findings of significant guttata and a prior history of RK. The mean age of presentation for cornea evaluation was 54.3 years (range: 38–72 years), averaging 18.7 years (range: 11–33 years) after RK. The presentation of guttata varied in degree from moderate to severe. Best corrected visual acuity (BCVA) ranged from 20/25 to 20/80. All patients had a history of bilateral RK, except one patient who did not develop any guttata in the eye without prior RK. No patients reported a family history of Fuch’s Dystrophy. One patient underwent a penetrating keratoplasty in one eye and a Descemet’s stripping automated endothelial keratoplasty (DSAEK) in the other eye.ConclusionsRK may induce a spectrum of endothelial degeneration. In elderly patients, the findings of guttata may signify comorbid Fuch’s dystrophy in which RK incisions could potentially hasten endothelial decomposition. In these select patients with stable cornea topography and prior RK, DSAEK may successfully treat RK endothelial degeneration.