Eintrübung einer hydrophilen Intraokularlinse 4 Jahre nach Kataraktoperation

Khoramnia, Ramin; Salgado, J.P.; Auffarth, Gerd U.; Schmidt, Sebastian; Wegner, A.; Ka, Kobuch; C, Winkler von Mohrenfels

doi:10.1007/s00347-011-2487-6

Cited by 28 publications

(33 citation statements)

References 10 publications

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“…Energy dispersive X-ray spectroscopy for elementary analysis of the composition of the deposits proves, that the deposits consist of calcium phosphate. This confirms the findings of other groups, who demonstrated calcium phosphate deposits in explanted IOLs using similar methods [ 2 , 3 , 7 , 10 , 13 , 18 , 21 ].…”

Section: Discussionsupporting

confidence: 92%

“…Clinically this translates into a reduction of brightness and contrast especially in mesopic conditions and ultimately to „foggy “or „clouded “vision and loss of overall visual acuity. We have shown similar results in faulty manufactured IOLs in earlier publications [ 3 , 21 ], but to our knowledge this is the first systematic examination of calcified IOL explants after posterior lamellar keratoplasty using an optical bench in a larger series.…”

Section: Discussionsupporting

confidence: 81%

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Hydrophilic intraocular lens opacification after posterior lamellar keratoplasty - a material analysis with special reference to optical quality assessment

et al. 2017

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BackgroundLaboratory analysis and optical quality assessment of explanted hydrophilic intraocular lenses (IOLs) with clinically significant opacification after posterior lamellar keratoplasty (DMEK and DSAEK).MethodsThirteen opacified IOLs after posterior lamellar keratoplasty, 8 after descemet stripping automated endothelial keratoplasty (DSAEK), 3 after descemet membrane endothelial keratoplasty (DMEK) and 2 after both DSAEK and DMEK were analysed in our laboratory. Analyses included optical bench assessment for optical quality, light microscopy, scanning electron microscopy (SEM) and energy dispersive X-Ray spectroscopy (EDS).ResultsIn all IOLs the opacification was caused by a thin layer of calciumphosphate that had accumulated underneath the anterior optical surface of the IOLs in the area spared by the pupil/anterior capsulorhexis. The calcifications lead to a significant deterioration of the modulation transfer function across all spatial frequencies of the affected IOLs.ConclusionsThe instillation of exogenous material such as air or gas into the anterior chamber increases the risk for opacification of hydrophilic IOLs irrespective of the manufacturer or the exact composition of the hydrophilic lens material. It is recommended to avoid the use of hydrophilic acrylic IOLs in patients with endothelial dystrophy that will likely require procedures involving the intracameral instillation of air or gas, such as DMEK or DS(A)EK.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 81%

Hydrophilic intraocular lens opacification after posterior lamellar keratoplasty - a material analysis with special reference to optical quality assessment

et al. 2017

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“…In opacified Aqua-Sense IOLs (Ophthalmic Innovations International Inc., Ontario, California) light microscopy and scanning electron microscopy analyses showed typical granular deposits on the surface the IOL [ 1 , 4 – 6 ]. Additionally granular deposits of different sizes lined parallel to the surface of the IOL optic were found using Alizarin Red as well as the von Kossa method for staining [ 1 , 4 ]. The deposits were generally located in the optic as well as the haptic region [ 4 – 6 ].…”

Section: Resultsmentioning

confidence: 99%

“…The calcification of hydrophilic IOLs is a very rare complication [ 1 ]. The intracameral injection of rtPA, gas or air seems to increase the risk of opacification [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Optical and material analysis of opacified hydrophilic intraocular lenses after explantation: a laboratory study

et al. 2015

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BackgroundThe opacification of hydrophilic intraocular lenses (IOLs) is a very rare complication in terms of absolute numbers. We report on the analyses of opacified Euromaxx ALI313Y and ALI313 IOLs (Argonoptics, Germany) using light and scanning electron microscopy, X-ray spectroscopy and optical bench analysis.MethodsOpacified Euromaxx ALI313Y and ALI313 IOLs were explanted after patients presented with a decrease in visual acuity. The explants were sent to our laboratory and examined using light and scanning electron microscopy. The composition of the deposits was analysed using X-ray spectroscopy. The optical quality of the intraocular lens (IOL) was assessed using the OptiSpheric IOL PRO optical bench (Trioptics GmbH Wedel, Germany). Modulation transfer function (MTF) was measured at all spatial frequencies and United States Air Force (USAF) 1951 resolution target pictures were documented.ResultsMacroscopically, the entire optic was opacified in all IOLs. Light and scanning electron microscopy revealed numerous fine, granular, crystalline-like deposits, which were always distributed in a line parallel to the anterior and posterior surfaces of the IOLs. X-ray spectroscopy could prove the deposits consisted of Calcium and Phosphate. Measurements in the optical bench showed deterioration of MTF values at all spatial frequencies and the USAF target pictures demonstrated a significant reduction of brightness as well as resolution with the opacified IOLs.ConclusionsThe calcification of hydrophilic IOLs only occurs rarely. The exact chemical composition of the deposits can be assessed by means of X-ray spectroscopy. Optical quality analysis of the explanted Euromaxx ALI313Y and ALI313 IOLs showed significant reduction of MTF values, which was confirmed by USAF target pictures.

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“… 12 The causes of primary IOL calcification lie within the polymer material, the lens manufacturing process and the lens packaging. 9 , 13 , 14 , 15 In contrast, secondary calcification is caused by environmental factors that can provoke calcification in any lens made of hydrophilic material. Factors that are considered to increase the risk of secondary calcification include surgical procedures with intraocular injection of gas, air or silicone oil (e.g.…”

Section: Introductionmentioning

confidence: 99%

Variation in intraocular lens calcification under different environmental conditions in eyes with supplementary sulcus-supported lenses

Yildirim

Khoramnia

Schickhardt

et al. 2020

American Journal of Ophthalmology Case Reports

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Purpose Analysis of explanted intraocular lenses (IOLs) from pseudophakic eyes with supplementary sulcus-supported IOLs. Methods In this laboratory investigation, ten supplementary and capsular bag IOLs were analyzed. All lenses were received between January 2012 and March 2018. Explants were examined morphologically with histological and electron microscopic techniques and patients’ medical history was evaluated. Additionally, we used a technique new to this field: Transmission Electron Microscopy and electron diffraction pattern analysis was performed to investigate the structure of the opacifying crystals in detail. Results Eleven lenses were explanted due to IOL opacification from seven polypseudophakic eyes: In three cases the supplementary lens calcified, in three cases the capsular bag IOL (both lenses analyzed) and in one case both IOLs (only the supplementary was received). Additional surgical procedures and comorbidities included pars plana vitrectomy or Descemet stripping endothelial keratoplasty and diabetes mellitus. For each opacified lens, a varying layer of a Calcium phosphate beneath the optic surface was apparent. Crystal characterization revealed its composition to be Hydroxyapatite. Conclusions and Importance We report on a series of secondary calcification in lenses explanted from polypseudophakic eyes. In some cases, calcification occurred in the capsular bag lens, in other cases in the supplementary lens, or in both. The severity of the morphological change could be related to the comorbidities and the presence of surgery subsequent to the lens implantations. Detailed morphology of the opacifying crystals was revealed.

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Eintrübung einer hydrophilen Intraokularlinse 4 Jahre nach Kataraktoperation

Cited by 28 publications

References 10 publications

Hydrophilic intraocular lens opacification after posterior lamellar keratoplasty - a material analysis with special reference to optical quality assessment

Hydrophilic intraocular lens opacification after posterior lamellar keratoplasty - a material analysis with special reference to optical quality assessment

Optical and material analysis of opacified hydrophilic intraocular lenses after explantation: a laboratory study

Variation in intraocular lens calcification under different environmental conditions in eyes with supplementary sulcus-supported lenses

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