Late Postoperative Opacification of the Foldable Hydrophilic Acrylic Intraocular Lens, ACRL-160

Kim, Hyun Gue; Lee, Su Hyung; Choi, Yul Je

Abstract

PURPOSE
To report pathological, histochemical, ultrastructural, and spectrographic analysis of explanted hydrophilic acrylic intraocular lenses obtained from patients who had visual disturbances caused by postoperative opacification of the IOL. METHODS: Forty-three hydrophilic IOLs (ACRL-160, Ophthalmed Inc.) were explanted from 39 patients with decreased visual acuity because of opacification of the IOL itself. All explanted IOLs were examined grossly and by light microscopy. Full-thickness sagittal sections of the optics of the randomly selected 10 IOLs were stained with the von kossa method (special stains for calcium). One of these sectioned IOLs was not stained, and submitted for scanning electron microscopy and energy dispersive X-ray spectroscopy. RESULTS: Microscopic analysis revealed multiple fine, granular deposits within the lens optics and haptics, and these deposits were stained positively with the von Kossa method. They were varible in size, and unevenly distributed in the optics on the scanning electron microscopy, and energy dispersive X-ray spectroscopy of the internal substance of IOL demonstrated the presence of calcium within the deposits. CONCLUSIONS: We evaluated 43 explanted opacified ACRL-160 lenses, and have demonstrated that the opacification was caused by the presence of granular deposits within the IOL. The deposits have the component of calcium.