Long-term pathological follow-up of 2-loop iridocapsular intraocular lens

Abstract

We analyzed an enucleated postmortem eye from an 86-year-old donor who had a 2-loop iridocapsular intraocular lens (IOL) that had been implanted at least 30 years earlier. High-frequency ultrasound showed a relatively well-centered iris-supported optic in front of the pupil. Gross and light microscopic analyses of the eye and the IOL showed loop fixation outside the capsular bag remnants, a thickened cornea, mild attenuation of the corneal endothelium, multiple areas of iris trauma secondary to haptic abrasion, fragments of iris tissue attached to the haptics, as well as pigment dispersion within the eye with pigmented epithelial cells attached to the IOL haptics. Histopathological examination of the posterior segment was unremarkable.

Case Report

“…These findings supported the experience that polymethylmethacrylate is well tolerated over the long term 5 and suggested that the IOL was correctly implanted with both loops inside the capsular bag. 6 The PEX material was found in the pupillary border associated with pupillary ruff atrophy, both characteristic signs of the PEX syndrome. 4 The PEX material also was found on the IOL surface in the left eye, which had been implanted more recently, suggesting that the PEX syndrome developed late and therefore the IOL was stable on the pupil for many years.…”

The six generations of the intraocular lens evolution

“…[1][2][3] We evaluated an enucleated postmortem eye from an 86-year-old donor with a 2-loop iridocapsular lens implanted 30 years earlier. 7 Although the IOL was relatively well-centered in the eye and the overall design and fixation were associated with some degree of stability, long-term biologic consequences such as corneal decompensation and pigment dispersion were observed because the loops still kept direct contact with the iris in some areas.…”