Microscopic analysis of opacification in Ioflex® hydrophilic acrylic intraocular lenses

Abstract

Five cases of intraocular lens (IOL) opacification in patients implanted with the Mediphacos Ioflex® IOL are described. Clinical data in each case was obtained from the patient's medical record. The five explanted IOLs underwent gross and light microscopic analysis. Selected lenses were processed for further evaluation and multiple sagittal cuts were stained with the alizarin red and von Kossa methods. Light microscope analysis confirmed the presence of deposits on and within the lens, which stained positive for calcium. The reason why calcification has occurred in these cases remains unclear, but surgeons should be aware of this potential late postoperative complication.Keywords: Lenses, intraocular; Lens implantation, intraocular; Reoperation; Device removal; Microscopy; Case reports RESUMO Cinco casos de opacificação de lente intraocular (LIO) em pacientes implantados com a LIO Ioflex® da Mediphacos são descritos. Os dados clínicos dos pacientes foram obtidos a partir dos prontuários médicos. As cinco LIOs explantadas foram enviadas para análise macroscópica e sob microscopia óptica. Algumas lentes foram processadas para análise adicional e múltiplos cortes sagitais foram corados pelos métodos de vermelho de alizarina e von Kossa. A análise sob microscopia óptica confirmou a presença de depósitos na superfície e no corpo da lente, que coraram positivamente para cálcio. A razão pela qual a calcificação ocorreu nestes casos permanece obscura. Entretanto, cirurgiões devem estar atentos para esta potencial complicação tardia.Descritores: Lentes intraoculares; Implante de lenteintraocular; Reoperação; Remoção de dispositivo; Microscopia; Relatos de casos 1 Fundação Altino Ventura -FAV -Recife (PE), Brazil;

Late Opacification of a Hydrophilic Acrylic Intraocular Lens in Europe

“…We report for the first time cases of late opacification of the Ioflex IOL in Europe, specifically in Czech Republic. Although histochemical and/or surface analyses were not performed, the aspect described here appears consistent with a process of calcification of this lens design (2)(3)(4)8). Gross and light microscopy of the explanted IOLs demonstrated the presence of granular deposits, which were predominantly located on the surface/subsurface of the IOLs, particularly the anterior surface.…”

“…Some previous studies have also reported cases of opacification of the Ioflex IOL (2-4, 8). Barra et al (2) reported 7 cases of IOL opacification in Brazilian centers.…”

Calcification of hydrophilic acrylic intraocular lens in eyes with silicone oil tamponade – an interventional case series report

“…; Ventura et al. ). The literature shows that the mean period varies from 16.4 to 35.3 months (Ventura et al.…”

“…The literature shows that the mean period varies from 16.4 to 35.3 months (Ventura et al. ). In our study, the diagnosis was late postoperatively.…”

Microscopic and spectroscopic investigation of an explanted opacified intraocular lens

“…Surprisingly similar SEM images were published [14] for a hydrophilic intraocular lens explanted from a patient with injection of intraocular gas. In earlier studies, the patterns of the opacifying deposits are described as characteristic ring-like crystalline structure [14], but also as "cerebriform" pattern [15][16][17][18]. The shape of the grains (Fig.…”