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Calcification in hydrophilic acrylic IOLs seen after intracameral injections of gas
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LONDON – Ophthalmologists should reconsider the use of hydrophilic acrylic IOLs in patients in whom further procedures using intracameral air or gas are anticipated, particularly DSEK or DSAEK, a speaker said here.
At the European Society of Cataract and Refractive Surgeons Congress, Liliana Werner, MD, PhD, reported seven cases of explanted hydrophilic acrylic IOLs that exhibited a specific pattern of calcification after such procedures.
Liliana Werner
“There is increasing evidence in the literature of this distinctive pattern of calcification of various hydrophilic acrylic lenses following procedures using intracameral injections of air or gas,” Werner said.
Opacification was located on the anterior surface of the lens in the central part of the optic and usually within the pupillary area or the capsulorrhexis area, she said.
In all of Werner’s reported cases, the opacification was reported between 1 and 6 months after the last surgery involving injection of air or gas. Patients reported a decrease in visual acuity and “foggy” vision. In all cases, vision improved after explantation and IOL replacement.
The IOLs involved six different designs from five manufacturers.
“There are other [cases] from other groups describing exactly the same thing. So, further investigation is necessary to determine if this localized calcification is a result of the direct contact between the IOL surface and the air or gas, or if the metabolic change in the anterior chamber is due to the presence of the air or gas – and we actually believe that that’s more likely – or even an exaggerated inflammatory reaction after multiple surgical procedures and multiple injections,” Werner said.
Disclosure: Werner has no relevant financial interests.