Intraocular lens opacification after corneal endothelial keratoplasty: Electron microscopy and x-ray element spectroscopy analysis

Park, Jonathan C.; Habib, Nabil E; Moate, Roy

doi:10.1016/j.jcrs.2014.05.035

Cited by 23 publications

(14 citation statements)

References 6 publications

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“…Although all four cases had rebubbling in this series, 1 in our recently published UK series only two of the five cases had rebubbling. 4 In our series, all five cases were also hydrophilic acrylic IOL's, although only one was a Rayner implant highlighting that this problem relates to hydrophilic acrylic material regardless of the manufacturer (other IOL's that opacified included Zeiss, STABIBAG; Lenstec, LH 3000; Bausch and Lomb, MI60 and Bausch and Lomb, Akreos). 4 We agree with the authors that patients requiring cataract surgery who are at risk of corneal endothelial failure (typically those with Fuchs' endothelial dystrophy)…”

mentioning

confidence: 67%

Intraocular lens calcification following endothelial keratoplasty: a message for all cataract surgeons

Park

Habib

Moate

2015

Eye

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mentioning

confidence: 67%

Intraocular lens calcification following endothelial keratoplasty: a message for all cataract surgeons

Park

Habib

Moate

2015

Eye

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“…Despite the marked progress in the field of new materials and intraocular implant production technology, the incidence of IOL opacification is common. [345678910111213141516] IOL opacification is a rare but significant complication after DSAEK. The incidence of IOL opacification after DSAEK ranged from approximately 5% of 160 eyes (8 eyes)[11] to 9.7% of 154 eyes (15 eyes)[7] in a large number of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Possible risk factors include an inflammatory reaction after multiple surgical procedures disrupting the blood–aqueous barrier,[4815] injection of exogenous air or gas into the AC,[61113] rebubbling after DSAEK,[10121415] and implantation of acrylic hydrophilic IOLs. [34578910111213141516]…”

Section: Discussionmentioning

confidence: 99%

Intraocular lens opacification after Descemet's stripping automated endothelial keratoplasty

Lee

Tsai

et al. 2017

Taiwan J Ophthalmol

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Compared with conventional penetrating keratoplasty, Descemet's stripping automated endothelial keratoplasty (DSAEK) more effectively maintain global integrity and rapid vision rehabilitation with less ocular surface disorders in patients with endothelial dysfunction. Here, we report a case of a 76-year-old woman who experienced opacification of a hydrophilic intraocular lens (IOL) approximately 10 months after DSAEK. The patient with no history of systemic disease developed pseudophakic bullous keratopathy in the right eye 2 years after undergoing cataract surgery. The best-corrected visual acuity (BCVA) of the right eye was Snellen 0.01 when presented to our hospital. DSAEK was arranged and performed smoothly. However, the graft detached over the upper part of the cornea on postoperative day 1. Thus, rebubbling was performed immediately. After the procedure, the graft was well attached, and the cornea became clear gradually. The BCVA returned to Snellen 0.6. However, progressive opacification over the anterior surface of the IOL was observed 10 months postoperatively. Vision deteriorated to 0.5 with various refractive errors during 2-year follow-up. IOL exchange may be considered if the vision is getting worse. IOL opacification may result from a direct contact between the IOL surface and exogenous air, particularly in a hydrophilic IOL, and can be a rare but significant complication after DSAEK. Clinicians planning to perform DSAEK should consider the composition of the IOL, the amount of intracameral air, duration of air filling, and high intraocular pressure.

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“…Dabei kann es nach DSAEK in 7-20% und nach DMEK in 33-81 % der Fälle [5] bei einer frühen Transplantatdislokation notwendig sein, die Vorderkammer wiederholt mit Luft füllen zu müssen, um eine dauerhafte Transplantatanlage zu erreichen. Dies könnte im Zusammenhang damit stehen, dass jüngst vereinzelt über Kunstlinsentrübungen nach hinterer lamellärer Keratoplastik berichtet wurde [3,[6][7][8][9][10][11][12][13]. Nachdem auch an der Klinik für Augenheilkunde einzelne Fälle von Kunstlinsentrübungen nach hinterer lamellärer Keratoplastik aufgefallen waren, wurden alle digitalen Akten von Patienten, die in den vergangenen Jahren eine perforierende Keratoplastik, eine DSAEK, eine DMEK oder nur eine Kataraktoperation erhalten hatten hinsichtlich der Auftretens einer Kunstlinsentrübung überprüft, um einen Anhalt für die Häufigkeit dieser schwerwiegenden Komplikation zu bekommen.…”

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Kunstlinsentrübungen nach hinterer lamellärer Keratoplastik

Maier

Heinzelmann

Böhringer

et al. 2015

Klin Monatsbl Augenheilkd

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In total we found seven cases of intraocular lens opacification that have only been observed following DSAEK or DMEK. According to reports from the literature these opacifications are superficial calicifications of the hydrophilic lenses. As five of the seven cases had a complicated clinical course, the repeated air contact of the lens could be one major factor in inducing the calcification. Besides the air contact a breakdown of the blood-aqueous barrier could also play a role in the induction of calcium phosphate crystallisation on the intraocular lens. The risk of this serious complication in mainly hydrophilic intraocular lenses with respect to posterior lamellar keratoplasty should be kept in mind for the selection of the type of intraocular lens in patients with endothelial diseases or in patients undergoing combined cataract extraction and DSAEK/DMEK.

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Intraocular lens opacification after corneal endothelial keratoplasty: Electron microscopy and x-ray element spectroscopy analysis

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

Cited by 23 publications

References 6 publications

Intraocular lens calcification following endothelial keratoplasty: a message for all cataract surgeons

Intraocular lens calcification following endothelial keratoplasty: a message for all cataract surgeons

Intraocular lens opacification after Descemet's stripping automated endothelial keratoplasty

Kunstlinsentrübungen nach hinterer lamellärer Keratoplastik

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