Serial opacification of a hydrophilic–hydrophobic acrylic intraocular lens: analysis of potential risk factors

Abstract

Purpose: To identify potential risk factors related to the opacification of a hydrophilic–hydrophobic acrylic intraocular lens (IOL) model. Setting: University Hospital Regensburg, Department of Ophthalmology, Regensburg, Germany. Design: Cross-sectional study. Methods: All patients with a Lentis LS-502-1 IOL implanted at the Department of Ophthalmology were identified. Existing medical records and information from the treating ophthalmologists were reviewed to determine the IOL status (clear or opacified). Potential risk factors were analyzed using binary logistic regression models. Results: A total of 223 IOLs of 199 patients were included. Sixty-seven (30.0%) opacified (calcified) IOLs were identified and compared with a control group of 156 IOLs. Statistical analyses revealed age at IOL implantation (odds ratio [OR] = 1.05, P = .012) to be associated with an increased risk of calcification. Posterior capsulotomy (OR = 0.45, P = .011) was found to have a protective influence. No other ophthalmic or systemic condition showed a significant association. Mean corrected distance visual acuity diminished significantly under opacification from 0.21 ± 0.25 logarithm of the correct minimum angle of resolution (logMAR) to 0.42 ± 0.32 logMAR (P < .001). IOL exchange in 55 of 67 cases at 45.8 ± 20.5 months after initial implantation yielded significant visual recovery (P = .001). Conclusions: Age at implantation might be a risk factor of IOL calcification, whereas posterior capsulotomy might be a protective factor. Calcification of the LS-502-1 IOL might be caused by the interaction of 3 main factors: IOL material traits, manufacturing-associated contamination, and patients’ individual factors altering intraocular ion concentrations.

Development of a standardized in vitro model to reproduce hydrophilic acrylic intraocular lens calcification

“…We found that those IOLs described as having hydrophobic surface properties (Table 2 ) also exhibited calcification, the surface did not impede crystallization. This finding is in agreement with previous reports 15 , 16 , 24 , 38 and it suggests that hydrophobic surfaces cannot prevent the diffusion of the ions into the polymer.…”

“…IOL calcification is associated with a number of risk factors: some hydrophilic IOL polymers appear more prone than others to calcification and opacification of IOLs of certain batches could be observed in the past 16 . Moreover, there is an association with some ophthalmic surgical procedures or with specific ocular and systemic diseases 8 , 9 , 15 – 20 .…”

Eintrübung von Intraokularlinsen: Erkenntnisse aus dem Labor und der Klinik

“…So zeigte beispielsweise eine kürzlich veröffentlichte Arbeit von Scherer und Kollegen, dass es in 223 Augen, welche mit einer entsprechenden IOL versorgt wurden, in 67 Fällen, also in 30,0 % der Fälle, zu einer Eintrübung kam. Die Autoren konnten bis auf ein minimal erhöhtes Risiko bei älteren Patienten (OR=1,05) keine anderen begünstigenden patientenabhängigen Faktoren feststellen, die das Risiko einer Kalzifikation erhöhen [ 28 ]. Somit scheint v. a. die Produktionsweise der IOL ausschlaggebend für das Auftreten der Pathologie zu sein.…”

Physicochemical Analysis of Sediments Formed on the Surface of Hydrophilic Intraocular Lens after Descemet’s Stripping Endothelial Keratoplasty

“…The literature on the subject discusses many cases of sedimentation, and also includes some ideas to describe this phenomenon [1,[3][4][5][6][7][8][9]24,[26][27][28][29][36][37][38][39][40][41]. Scherer, N C. D et al in recent investigations [61] by detailed statistical analysis of a series of 223 explanted Lentis LS-502-1 IOLs revealed as a calcification risk factor an age at implantation. The direct cause of calcification is associated with the interplay between IOLs' material characteristics, contamination resulting from manufacturing, and patient individual conditions [61].…”

“…Scherer, N C. D et al in recent investigations [61] by detailed statistical analysis of a series of 223 explanted Lentis LS-502-1 IOLs revealed as a calcification risk factor an age at implantation. The direct cause of calcification is associated with the interplay between IOLs' material characteristics, contamination resulting from manufacturing, and patient individual conditions [61]. In turn, comorbidities and the presence of surgery subsequent to the lens implantations are suspected as causes of secondary calcification in lenses explanted from polypseudophakic eyes [62].…”