Intrastromal opacification noted after intracorneal inlays

Intrastromal epithelial opacification can develop postoperatively in eyes implanted with hydrogel intracorneal inlays for the correction of hyperopia, according researchers in Spain.

Jorge L. Alió, MD, PhD, and colleagues reported the complication in a series of 11 eyes of seven patients implanted with hydrogel corneal inlays. Postoperatively, five of the 11 eyes developed perilenticular corneal opacities, which were evident by 1 week follow-up and were thought to be directly related to the intracorneal inlays.

The opacities appeared similar to diffuse lamellar keratitis but were limited to the edges of the inlays. All patients complained of similar symptoms, including night glare, photophobia, starbursts and blurry vision, according to the study authors.

In all five cases, corneal transparency improved following implant removal and treatment with topical antibiotics and steroids. A mild stromal opacity remained around the periphery of the central cornea in two eyes but did not affect transparency of the central cornea, the authors said.

All cases tested negative for bacteria, fungi and mycobacteria, they noted. Confocal microscopy showed images compatible with epithelial cells, and histopathologic study showed the presence of epithelial cells, they said.

The researchers named the phenomenon, which they said has not been previously reported, epithelial perilenticular opacity. Their study is published in Archives of Ophthalmology.