Methods Twenty one eyes which underwent uncomplicated phacoemulsification and Hydroview lens implantation with good visual recovery, presenting at 46-146 weeks post-surgery with visual deterioration and glare symptoms resulting from opacification of the implants, were included in the study. Twelve eyes had severe opacification, of which nine underwent intraocular lens exchange and three more are still awaiting surgery. The method of explantation is described. The explanted intraocular lenses were examined using light microscopy, scanning electron microscopy and x-ray microanalysis using a light element detector. Results Light microscopy and scanning electron microscopy revealed diffuse granular deposits of approximately 5 m diameter covering the optic surfaces but sparing the lens haptics. Light microscopic staining techniques and x-ray microanalysis confirm the major component of the deposits to be calcium phosphate salts. Conclusions Late opacification of Hydroview intraocular lens implants is uncommon and aetiology seems to be multifactorial. Implant exchange is necessary to restore sight in some cases. As new materials are increasingly used it is important to highlight such unusual occurrences. Eye (2002) 16, 69-74.
Retrobulbar haemorrhage is an uncommon but well-documented complication of retrobulbar anaesthetic blocks in ocular surgery. Peribulbar anaesthesia has been advocated to be equally effective but safer. The incidence of retrobulbar haemorrhage with peribulbar blocks is very low. We report a case in which a peribulbar anaesthetic for cataract surgery resulted in sight-threatening retrobulbar haemorrhage within the medial rectus muscle and required an anterior orbitotomy and direct decompression of the muscle. The surgery was successful. This case illustrates a potentially serious complication of peribulbar anaesthesia, with the successful outcome achieved by rapid definitive diagnosis and intervention.
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