Hydroview lens implant calcification: 186 exchanges at a district general hospital

Abstract

Aim This paper describes the experience at a district general hospital of coping with an abrupt onset of calcification of Hydroview intraocular lens (IOL) implants requiring exchange surgery mostly for symptoms of glare, even though the visual acuities were relatively good. Methods In this retrospective study, the operative details of 174 consecutive lens exchanges by one surgeon were retrieved from the surgeon's notes. Of these, pre and postoperative details of 106 consecutive patients were obtained from the hospital notes. Results Of the 174 lens exchanges, all were sutureless except one and 31 eyes (18%) had had previous capsulotomies. Of 143 eyes with intact posterior capsules, eight (5.6%) needed anterior vitrectomy. Lens replacements were in the bag in 136 (95%), in the sulcus in five (3.5%), and in the anterior chamber in two (1.5%). Of the 31 eyes with previous capsulotomies, 10 (32%) needed anterior vitrectomy. Lens replacements were in the bag in 22 (71%) and in the sulcus in the remaining nine cases (29%). Postoperatively the bestcorrected visual acuity was improved in 53%, remained the same in 35%, and deteriorated in 12%. Conclusion The lens exchange procedure was mostly predictable with satisfactory visual results allowing preoperative counselling of risks to be similar to that for cataract surgery. The onset and resolution of the period of implantation of lenses requiring exchange has not been explained.

Regarding the paper: Hydroview lens implant calcification—186 exchanges at a district general hospital, by P Syam et al

“…They also render the explantation procedure more challenging. Out of the eyes with intact posterior capsules in the study by Syam et al, 10 5.6% needed anterior vitrectomy, against 32% of the eyes with previous capsulotomies. We have also demonstrated in previous studies that Nd:YAG laser applications cannot clean the optic surfaces of the IOL of the calcified deposits.…”

“…There are many others issues involved with the recall of patients, as described in the study by Syam et al 10 Despite the fact that there are questions about product liability and who covers the costs for additional surgical procedures (lens exchange etc), we feel it is important that in any individual case the patient's well-being should be the guideline for mutual actions taken by the doctor, manufacturer, and health authorities.…”

The effect on visual function of Hydroview intraocular lens opacification: a cross-sectional study

“…Opacification of the optic of implanted intraocular lenses (IOLs) is a rare, but important postoperative complication that can affect visual function to the point that IOL exchange is required. [3][4][5][6] Optic opacification can be either a primary or secondary phenomenon, the former being because of a problem with the IOL itself and the latter a consequence of the intraocular environment, for example uveitis. 7 Although any IOL can be affected by secondary opacification, primary opacification appears more common in hydrophilic acrylic IOLs, having been associated with the Aquasense (Ophthalmic Innovation International, Ontario, Canada), 8 MemoryLens (Ciba Vision, Duluth, GA, USA), [9][10][11] SC60B-OUV (Medical Development Research, Clearwater, FL, USA), [12][13][14][15] and the Hydroview H60M IOL (Bausch and Lomb, Rochester, New York, NY, USA).…”

Calcification of Hydroview lenses implanted in the United Kingdom during 2000 and 2001

“…Although chloro-PPD has been reported earlier to cause allergic contact dermatitis, but blepharoconjunctivitis is very rare and only one case has so far been reported in literature. 1,2 This may be due to either rarity of allergic reaction or due to underreporting.…”

“…[1][2][3] None of the affected hospitals were routinely using Viscoat, known by this time to be associated with calcification of Hydroview lenses. 4,5 A total of 474 implants, out of 8239 lenses implanted between September 2000 and April 2001 at the seven hospitals, were explanted because of calcification (5.8%, Table 1).…”