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IOL opacity attributed to chemical contamination, water vapor
NEW ORLEANS — Opacification of silicone intraocular lenses was attributed to chemical contamination that caused lens surface changes and allowed water vapor to disrupt vision, a study here showed.
Presenting at the American Academy of Ophthalmology meeting, Liliana Werner, MD, PhD, showed how unopened silicone intraocular lenses were found to be compromised by various chemicals and discussed improvements made in packaging to prevent future contamination.
"Since these improvements, there have been no further reports of late opacification," she said.
The study focused on 20 IOLs that were removed from patients because of optic opacification, Dr. Werner said. The IOLs included seven Tecnis (AMO), five CeeOn 913A (AMO), one CeeOn 911 (AMO), five SI40NB (AMO), and two Array SA40N (AMO) IOLs.
Opacification occurred 4 weeks to 2 years after cataract surgery and implantation. Explantation took place 2 to 24 months after surgery.
Gas chromatography and mass spectrometry of the lens surfaces showed ketones in five cases and benzophenones in seven cases, as well as other chemicals, Dr. Werner said. The identified chemicals are present in pesticides, cleaning solutions and other products, she noted.
Contrary to expectations, researchers found that water and not deposits caused the opacification. Researchers found that foreign chemicals changed the lens surfaces, causing excess water vapor to enter the optics and result in opacification. Water vapor diffused into the lens when the lens was in the aqueous, causing light to scatter, she said.
Findings led to improvements in packaging making them less vapor permeable in order to help prevent contamination, Dr. Werner said. Office personnel should avoid storing packaged IOLs near insecticides and cleaning products, she added.