Intraocular Lens Opacifications in Descemet Stripping Endothelial Keratoplasty Patients

Abstract

IOL opacification can occur in eyes previously subjected to DSEK. The majority of patients subjected to DSEK are pseudophakic; surgeons should be aware of this possible complication. To the best of our knowledge, this has not been described in the literature to date. Further research is required to elucidate the nature of such IOL opacifications and possible ways to prevent them.

Microscopic analysis of an opacified OFT CRYL® hydrophilic acrylic intraocular lens

“…This was our first case of opacification. Thus, this IOL should not be discredited based on the current report, which supports the hypothesis that intracameral gas can act as a trigger of hydrophilic lens calcification (2)(3)(4)(5)(6)(7)(8)(9) . Together with previous articles (2)(3)(4)(5)(6)(7)(8)(9) , the present report suggests that hydrophilic IOLs should be avoided in eyes that require procedures associated with intracameral presence of air or gas.…”

“…Similarly to the pattern seen in the Oft Cryl® IOL, calcification within the pupillary and anterior capsulorrhexis margins has been described in eyes in which gas or air 1) was injected intracamerally to treat Descemet's membrane detachment, to aid in graft adherence in endothelial transplants; 2) was injected to treat hypotony following trabeculoplasty; or 3) went into the anterior chamber after injection in the vitreous cavity to treat retinal detachment and ocular hypotony (2)(3)(4)(5)(6)(7)(8) . In these lenses, calcium granules were also found on the surface and subsurface of the IOLs.…”

“…Previous papers have described cases of IOL opacification in hydrophilic acrylic IOLs from different manufacturers (2)(3)(4)(5)(6)(7)(8)(9)(10)(11) . However, to the best of our knowledge, this is the first peer-reviewed report on Oft Cryl® IOL opacification.…”

“…Recently, opacification associated with the presence of gas or air in the anterior chamber has been reported (2)(3)(4)(5)(6)(7)(8)(9) . Since 2005, the single-piece hydrophilic acrylic Oft Cryl® IOL (Oft Vision, São Paulo, Brazil) has been largely used in Brazil; however, no case of lens opacification has been reported in the peer-reviewed scientific literature.…”

Localized opacification of hydrophilic acrylic intraocular lenses after procedures using intracameral injection of air or gas

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18] There is increasing evidence of a distinctive pattern of calcification of various hydrophilic acrylic IOL designs following procedures using intracameral injections of air or gas. [19][20][21][22][24][25][26][27] Calcification was localized to the anterior surface/subsurface of the IOL and within the pupillary or capsulorhexis area. Poor quality of vision through the opacification has generally required IOL exchange.…”