Piggyback PC IOLs were explanted in 2 cases because of a newly described complication, interlenticular opacification. Three surgical means may help prevent this complication: meticulous cortical cleanup, especially in the equatorial region; creation of a relatively large continuous curvilinear capsulorhexis to sequester retained cells peripheral to the IOL optic within the equatorial fornix; insertion of the posterior IOL in the capsular bag and the anterior IOL in the ciliary sulcus to isolate retained cells from the interlenticular space.

Although a silicone IOL shows maximal adherence to silicone oil, other lens biomaterials are not immune to this complication. Silicone oil coverage was related to the dispersive energy component of the surface charge of the IOL biomaterial. Low dispersive energy materials had less silicone oil coverage, while those with higher dispersive energy had more oil coverage.

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We report the results of laser in situ keratomileusis (LASIK) in a 58-year-old woman with a history of corneal guttata in the right eye and mild Fuchs' dystrophy in the left eye. Preoperative pachymetry was 586 microm and 656 microm, respectively. The surgical treatment was +1.50 diopters (D) in the right eye and +3.25 D in the left eye. Surgery was performed using a VISX S2 Star laser and a Hansatome microkeratome with a 9.5 mm ring. Postoperatively, edema in the right eye resolved and pachymetry returned to 585 microm, but the left cornea decompensated despite maximum medical therapy and had a final pachymetry of 779 microm. The patient was referred to our cornea service for penetrating keratoplasty, which was performed 14 months after the LASIK treatment.