J Korean Ophthalmol Soc.  2016 Dec;57(12):1958-1963. 10.3341/jkos.2016.57.12.1958.

Posterior Surface Opacification of a Silicone Intraocular Lens in a Patient with Asteroid Hyalosis

• Sun HJ
• Oh JR
• Kwon HS
• Lee SJ

• KMID: 2362716
• DOI: http://doi.org/10.3341/jkos.2016.57.12.1958

Abstract

PURPOSE
In the present study, a case of posterior surface opacification of a silicone intraocular lens (IOL) in a patient with asteroid hyalosis (AH) is reported.
CASE SUMMARY
76-year-old male was referred to our clinic with IOL opacification in his left eye. The patient had uneventful cataract surgery 7 years prior with the same silicone IOL implanted in both eyes. Three years after surgery, posterior capsular opacity was observed in his left eye and neodymium:YAG (Nd:YAG) laser capulotomy was performed. After posterior capsulotomy, opacification of the IOL's posterior surface was observed on slit lamp examination. IOL exchange was performed and the explanted IOL was analyzed using a light microscope and a scanning electron microscope with energy dispersive X-ray spectroscopy for elemental analysis of the deposits. The calcification was on the posterior surface of the IOL and composed mainly of calcium and phosphorus, the main components of AH. The right eye showed clear IOL with intact posterior lens capsule.
CONCLUSIONS
Surgeons performing cataract surgery should consider the possibility of surface calcification of silicone IOLs in eyes with AH before IOL selection for implantation.

Keyword

Asteroid hyalosis; Calcification; Opacification; Silicone intraocular lens

MeSH Terms

Aged
Calcium
Cataract
Humans
Lenses, Intraocular*
Male
Phosphorus
Posterior Capsulotomy
Silicon*
Silicones*
Slit Lamp
Spectrometry, X-Ray Emission
Surgeons
Calcium
Phosphorus
Silicon
Silicones

Figure

• 

  Figure 1. Anterior segment photograph of the left eye. Opacification of the intraocular lens is seen within the neo-dymium:YAG posterior capsulotomy margin.

• 

  Figure 2. B scan image of the right (OD) and left (OS) eye. B scan shows vitreous opacity in both eyes which are asteroid bodies.

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  Figure 3. Gross photograph of the explanted AMO ClariFlex® lens. It shows calcifications on the central optic zone where neodymium:YAG posterior capsulotomy was performed.

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  Figure 4. Light photomicrograph of the posterior aspect of the explanted intraocular lens. It shows deposits on the posterior surface, showing thick crustlike appearance with cracks in between the deposits (original magnification, ×100).

• 

  Figure 5. Scanning electron photomicrograph images. Sanning electron photomicrograph from the posterior optic surface with original magnification, ×300 (A), ×500 (B) and ×1,000 (C). The deposits are amorphous, confluent and multilayered which presents a crustlike and plate-like appearance.

• 

  Figure 6. X-ray spectroscopy spectrum of the clear zone (area 1) and zone with deposits (area 2). Peaks of calcium (Ca) and phosphate (P) are seen in the area with deposits. OK = oxygen; PK = phosphorus; CIK = chlorine; CaK = calcium; SiK = silicon.

Reference

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