Opacification of a silicone intraocular lens caused by calcium deposits on the optic

Wackernagel, Werner; Ettinger, Karl; Weitgasser, Ursula; Bakir, Berin Gŭl; Schmut, O.; Goessler, Walter; Faschinger, Christoph

doi:10.1016/s0886-3350(03)00672-2

Cited by 46 publications

(37 citation statements)

References 11 publications

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“…14,15 Finally, the occurrence of dystrophic calcification of silicone lenses has been described in eyes with asteroid hyalosis. [16][17][18] More recently, Tanaka et al 19 observed a phenomenon similar to the 6 cases described here in an 83-year-old Japanese patient who had implants with the same IOL design (SI40 NB). The IOL presented with a ''brown haze'' on the first postoperative day.…”

Section: Discussionsupporting

confidence: 79%

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Early opacification of silicone intraocular lenses: Laboratory analyses of 6 explants

Werner

Dornelles²,

Hilgert³

et al. 2006

Journal of Cataract and Refractive Surgery

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Most IOLs are enclosed in semipermeable packages to allow sterilization by ethylene oxide gas. During cleaning or disinfection of storage rooms, aerosolized solutions may introduce chemicals through the package and onto the IOLs. This may cause surface changes in the IOL, promoting opacification by water ingress in the aqueous environment. Cleaning and disinfection procedures of IOL storage areas should be monitored carefully.

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Section: Discussionsupporting

confidence: 79%

“…However, the latter has been observed only in eyes with associated asteroid hyalosis. [16][17][18] Tanaka et al 19 recently reported a case of optic haze of a 3-piece silicone lens, observed on the first postoperative day. One author of the current study had 4 similar cases with the same lens design and reported the clinical aspects.…”

mentioning

confidence: 99%

Early opacification of silicone intraocular lenses: Laboratory analyses of 6 explants

Werner

Dornelles²,

Hilgert³

et al. 2006

Journal of Cataract and Refractive Surgery

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“…[32][33][34] Four cases were initially reported in the literature, all with silicone plate IOLs in patients with unilateral asteroid hyalosis. 32,33 White deposits appeared late postoperatively on the posterior optic surface only. Two of the 4 reported patients had diabetes.…”

Section: Late Postoperative Iol Opacification/discoloration Silicone mentioning

confidence: 99%

Causes of intraocular lens opacification or discoloration

Werner¹

2007

Journal of Cataract and Refractive Surgery

151

101

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Various pathologic processes may lead to clinically significant opacification or discoloration of the optic component of intraocular lenses (IOLs) manufactured from different biomaterials and in different designs. Factors such as the patient's associated conditions, the manufacturing process, the method of IOL storage, the surgical technique and adjuvants, or a combination of these may be involved. The complication may be observed intraoperatively or postoperatively from a few hours after implantation to many years after surgery, depending on the processes involved. Based on a review of the literature as well as our own laboratory analyses, the following types of processes were identified: formation of deposits/precipitates on the IOL surface or within the IOL substance; opacification by excess influx of water in hydrophobic materials; direct discoloration by capsular dyes or medications; coating by substances such as ophthalmic ointment and silicone oil; and a slow, progressive degradation of the IOL biomaterial.

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“…Chemical composition of the Allergan silicone IOLs and the sterilization method used were the causes of the haze formation [28, 29]. Wackernagel et al [30] described opacification of a plate-haptic silicone IOL (Chiron Vision C10UB plate-haptic silicone lens) caused by calcification in a diabetic patient with asteroid hyalosis after Nd:YAG laser capsulotomy. Analysis of the lens surface showed calcium, phosphate, and oxygen on corresponding locations within a larger agglomeration of deposits.…”

Section: Discussionmentioning

confidence: 99%

Effect of Ultraviolet B Radiation on the Absorption Characteristics of Various Intraocular Lenses

Koçak

Kaynak

İlknur³

et al. 2006

Ophthalmologica

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Background: The aim of this study was to determine the effect of ultraviolet B (UVB) exposure on UV filters of various intraocular lenses (IOLs). Methods: Eight samples each of the hydrophobic acrylic, hydrophilic acrylic and silicone IOLs were used. Four IOLs of each type was selected randomly as the control group while the remaining four IOLs of each type were exposed to a UVB dose of 1.4 J/cm² (2.40 mW/cm²) for 9.45 min, two times with a 4-week interval. IOLs were evaluated for any sign of opacification under microscope weekly. After a follow-up period of 16 weeks, spectrometry for UV filter absorption rates, scanning electron microscopy for deposit formation and energy dispersive X-ray analysis for elemental composition were performed for all IOLs, and findings of the control group IOLs were compared with those of the UVB-exposed IOLs. All these procedures were done at the Department of Ophthalmology, Faculty of Medicine, Dokuz Eylul University. Results: All the IOLs were free of any opacification during the follow-up period. Spectrometric analysis of their UV filters revealed a change in absorption rates in the hydrophilic acrylic and silicone IOLs compared to the control IOLs of the same type. Only the hydrophobic acrylic IOLs preserved the same UV absorption curve after UVB exposure. Conclusion: The pathogenesis of IOL opacification is still undetermined. Some reports claimed that the UV light was the responsible factor. Our experimental study revealed that high doses of UVB did not cause any opacification though they impaired the function of UV filters of the hydrophilic acrylic and silicone IOLs.

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Opacification of a silicone intraocular lens caused by calcium deposits on the optic

Cited by 46 publications

References 11 publications

Early opacification of silicone intraocular lenses: Laboratory analyses of 6 explants

Early opacification of silicone intraocular lenses: Laboratory analyses of 6 explants

Causes of intraocular lens opacification or discoloration

Effect of Ultraviolet B Radiation on the Absorption Characteristics of Various Intraocular Lenses

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