A New Classification of Calcification of Intraocular Lenses

Neuhann, Irmingard M.; Kleinmann, Guy; Apple, David J.

doi:10.1016/j.ophtha.2007.02.016

Cited by 112 publications

(123 citation statements)

References 24 publications

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“…Nd:YAG laser treatment is ineffective in removing the calcified deposits from the lenses (1,(3)(4)(5) , as seen in most of our cases. The only effective treatment to restore vision is explantation and exchange of the calcified IOL.…”

Section: Discussionmentioning

confidence: 55%

“…The IOLs in each of these cases came from different lots, which might have had different susceptibilities to develop the complication. Previous papers have described IOL calcification in patients with ocular diseases, such as uveitis and asteroid hialosis (this latter in relation to silicone IOLs) (1,15) . Besides diabetic and hypertensive retinopathy in case 3, none of our cases had other past ocular inflammatory diseases.…”

Section: Discussionmentioning

confidence: 99%

“…ostoperative optic opacification is the leading cause of explantation of hydrophilic acrylic intraocular lens (IOL) (1) . The Mediphacos Ioflex ® (Belo Horizonte, Minas Gerais, Brazil) IOL is a foldable hydrophilic acrylic single-piece IOL with an optic diameter of 5.7 mm and an overall diameter of 12.5 mm.…”

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confidence: 99%

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Microscopic analysis of opacification in Ioflex® hydrophilic acrylic intraocular lenses

Ventura

Lira

et al. 2012

Rev. bras.oftalmol.

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Five cases of intraocular lens (IOL) opacification in patients implanted with the Mediphacos Ioflex® IOL are described. Clinical data in each case was obtained from the patient's medical record. The five explanted IOLs underwent gross and light microscopic analysis. Selected lenses were processed for further evaluation and multiple sagittal cuts were stained with the alizarin red and von Kossa methods. Light microscope analysis confirmed the presence of deposits on and within the lens, which stained positive for calcium. The reason why calcification has occurred in these cases remains unclear, but surgeons should be aware of this potential late postoperative complication.Keywords: Lenses, intraocular; Lens implantation, intraocular; Reoperation; Device removal; Microscopy; Case reports RESUMO Cinco casos de opacificação de lente intraocular (LIO) em pacientes implantados com a LIO Ioflex® da Mediphacos são descritos. Os dados clínicos dos pacientes foram obtidos a partir dos prontuários médicos. As cinco LIOs explantadas foram enviadas para análise macroscópica e sob microscopia óptica. Algumas lentes foram processadas para análise adicional e múltiplos cortes sagitais foram corados pelos métodos de vermelho de alizarina e von Kossa. A análise sob microscopia óptica confirmou a presença de depósitos na superfície e no corpo da lente, que coraram positivamente para cálcio. A razão pela qual a calcificação ocorreu nestes casos permanece obscura. Entretanto, cirurgiões devem estar atentos para esta potencial complicação tardia.Descritores: Lentes intraoculares; Implante de lenteintraocular; Reoperação; Remoção de dispositivo; Microscopia; Relatos de casos 1 Fundação Altino Ventura -FAV -Recife (PE), Brazil;

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Microscopic analysis of opacification in Ioflex® hydrophilic acrylic intraocular lenses

Ventura

Lira

et al. 2012

Rev. bras.oftalmol.

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“…Using microscopic analyses of explanted hydrophilic acrylic IOLs, Werner et al revealed multiple fine, calcified granular deposits of variable sizes within the lens optics (13) . Neuhann et al concluded that it was important to determine whether the calcium deposits formed because of a problem in IOL manufacturing (properties of the polymer, its surface, or the IOL packaging) or were the result of environmental causes that can catalyze calcification (14) . In the present study, five of the six patients with IOL opacifications had a history of diabetes mellitus, which may have contributed to IOL opacifications by catalyzing calcification.…”

Section: Discussionmentioning

confidence: 99%

Intraocular lens explantation or exchange: indications, postoperative interventions, and outcomes

Oltulu¹,

Erşan²,

Şatırtav³

et al. 2015

Arquivos Brasileiros De Oftalmologia

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Cataracts are one of the most common eye diseases associated with blindness (visual acuity worse than 20/400 in the better eye with best correction) worldwide, with an estimated 18 million people thought to be affected, and cataract surgery is the intraocular procedure performed most often worldwide. Over the years, the techniques of cataract surgery have evolved into a safe and successful procedure for visual rehabilitation. The incidence of most complications has significantly decreased with the development of better instrumentation and affordable, high-quality intraocular lens (IOL) implants (1) . Various aspects of cataract surgery that make it safer have changed ABSTRACT Purpose: To analyze the indications for explantation or exchange of intraocular lenses (IOLs), which were originally implanted for the correction of aphakia during cataract extraction. Methods: All cases that involved intraocular lens explantation or exchange in one institution between January 2008 and December 2014 were analyzed re tros pectively. Results: In total, 93 eyes of 93 patients were analyzed. The median time interval between implantation and explantation of the anterior chamber intraocular lenses (AC IOL) and posterior chamber intraocular lenses (PC IOL) was 83.40 ± 83.14 months (range: 1-276 months) and 55.14 ± 39.25 months (range: 1-168 months), respectively. Pseudophakic bullous keratopathy (17 eyes, 38.6%) and persistent iritis (12 eyes, 27.8%) in the AC IOL group and dislocation or decentration (30 eyes, 61.2%) and incorrect IOL power (nine eyes, 18.4%) in the PC IOL group were the most common indications for explantation of IOLs. The mean logMAR best corrected visual acuity (BCVA) improved significantly from 1.30 preoperatively to 0.62 postoperatively in the PC IOL group (p<0.001) but did not improve significantly in the AC IOL group (p=0.186). Conclusions:The primary indication for IOL explantation or exchange was pseudophakic bullous keratopathy in the AC IOL group and was dislocation or decentration in the PC IOL group. PC IOL explantation or exchange is safe and im proves visual acuity.

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“…11,17 Papers evaluating medical illness in association with IOL opacification suggest that a mechanism of bloodaqueous barrier impairment seemed to be associated with this postsurgical complication. 18 According to the literature, hydrophilic acrylic IOLs are likely to develop calcification when the concentrations of calcium, phosphate and albumin in the aqueous humor fluctuate due to blood-aqueousbarrier breakdown or other factors.…”

Section: B Discussionmentioning

confidence: 99%

Case-control study for clinical findings on intraocular lens opacity

Jorge¹,

Jorge²,

Ventura³

et al. 2014

Medical Express

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OBJECTIVE: To evaluate clinical features of patients related to opacification of hydrophilic acrylic intraocular lenses, four years after surgery. METHODS: We evaluated six cases of late opacification of Ioflex intraocular lenses (case group) compared to 24 patients (control group) with no opacification. Both groups underwent phacoemulsification as a result of a community campaign for underprivileged people. Patients who underwent bilateral cataract surgery had only the right eye included on the study. The patients were submitted to ophthalmic examination, including measurements of corrected distance visual acuity and biomicroscopy slitlamp evaluation. Detailed medical histories were obtained. Surgical details were retrieved. RESULTS: Systemic arterial hypertension was recorded in 4 patients from the case group and 11 in the control group, with no statistically significant difference between groups. A single patient in the control group had diabetes mellitus, and so was not considered for statistical analysis. No environmental factor could be related. There were no statistically significant differences for mean visual acuity between the groups of patients regarding the evaluation periods. One eye in the control group received an Ioflex intraocular lens with the same lot number as one of the opacified lenses. CONCLUSION: No clear patient factor could be related to late Ioflex lens opacification.

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A New Classification of Calcification of Intraocular Lenses

Cited by 112 publications

References 24 publications

Microscopic analysis of opacification in Ioflex® hydrophilic acrylic intraocular lenses

Microscopic analysis of opacification in Ioflex® hydrophilic acrylic intraocular lenses

Intraocular lens explantation or exchange: indications, postoperative interventions, and outcomes

Case-control study for clinical findings on intraocular lens opacity

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