J Korean Ophthalmol Soc.  2018 Oct;59(10):974-977. 10.3341/jkos.2018.59.10.974.

Two Cases of Intraoperative Acute Opacification of Hydrophilic Intraocular Lens

• Park HS
• Kim YM
• Yang JY

• KMID: 2422587
• DOI: http://doi.org/10.3341/jkos.2018.59.10.974

Abstract

PURPOSE
In the present study, two cases of intraoperative acute opacification of hydrophilic intraocular lens were reported.
CASE SUMMARY
(Case 1) A sixty-seven year-old female presented with chronic visual impairment. Slit lamp examination revealed nuclear cataract of the left eye. Cataract surgery for her left eye was performed. A hydrophilic intraocular lens was checked before implantation and no defect was noted. Immediately after the implantation of the intraocular lens, acute whitish opacification of the intraocular lens occurred. However, the intraocular lens was not explanted, and the opacification cleared after one day. (Case 2) A 65 year-old male presented with chronic visual impairment of the left eye. Nuclear cataract of his left eye was noted, and he went through cataract surgery of the left eye. After the implantation of intraocular lens, acute whitish opacification of the intraocular lens was noted but it disappeared a day after.
CONCLUSIONS
Intraoperative acute opacification of intraocular lens seems to occur due to radical temperature change. There is no need to remove or exchange the intraocular lens as opacification tends to clear within a day. No structural or mechanical change of intraocular lens was noted after opacification. Careful management of temperature for intraocular lens storage is necessary for prevention of intraoperative intraocular lens clouding.

Keyword

Intraocular lens; Opacification

MeSH Terms

Cataract
Female
Humans
Lenses, Intraocular*
Male
Slit Lamp
Vision Disorders

Figure

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  Figure 1 Transparent intraocular lens before implantation. Note the transparent lens immediately after the opening of the container (A) and when positioned in injector (B).

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  Figure 2 Clouding of intraocular lens at the beginning of implantation and immediately after implantation. (A) Clouding of intraocular lens was noted at the beginning of implantation. (B) Clouding of intraocular lens was remained immediately after implantation.

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  Figure 3 Completely cleared intraocular lens at postoperative day 1. Note the cleared lens with broad beam.

Reference

1. Taşkapılı M, Kocabora S, Kandemir N, et al. The results of exchange surgery in the eyes with opacified intraoculerintraocular lens. Glo-Kat. 2008; 3:15–19.

2. Ozcetin H, Akova B, Toprak A, et al. Clinic in pseudocataract. T Oft Gaz. 2006; 36:229–233.

3. Izak AM, Werner L, Pandey SK, Apple DJ. Calcification of modern foldable hydrogel intraocular lens designs. Eye (Lond). 2003; 17:393–406.

4. Neuhann IM, Werner L, Izak AM, et al. Late postoperative opacification of a hydrophilic acrylic (hydrogel) intraocular lens: a clinicopathological analysis of 106 explants. Ophthalmology. 2004; 111:2094–2101.

5. Pandey SK, Werner L, Apple DJ, Gravel JP. Calcium precipitation on the optical surfaces of a foldable intraocular lens: a clinicopathological correlation. Arch Ophthalmol. 2002; 120:391–393.

6. Tehrani M, Mamalis N, Wallin T, et al. Late postoperative opacification of MemoryLens hydrophilic acrylic intraocular lenses: case series and review. J Cataract Refract Surg. 2004; 30:115–122.

7. Lee CE, Kim YC, Chang SD. Opacification of the optic of an Akreos adapt intraocular lens. Korean J Ophthalmol. 2010; 24:371–373.

8. Cao D, Zhang H, Yang C, Zhang L. Akreos Adapt AO Intraocular lens opacification after vitrectomy in a diabetic patient: a case report and review of the literature. BMC Ophthalmol. 2016; 16:82.

9. Tyagi P, Shah N, Jabir M. Intraoperative clouding of a posterior chamber intraocular lens. Int Ophthalmol. 2011; 31:483–484.

10. Helvaçi S. Acute opacification of hydrophobic acrylic intraocular lens during implantation: result of temperature variation. Arq Bras Oftalmol. 2015; 78:267.

11. Liu Q, Zhang S, Wang X, et al. Acute clouding of trifocal lens during implantation: a case report. BMC Ophthalmology. 2017; 17:242.