Etiology, pathogenesis, and management of acute intraocular lens opacification: a systematic review

Abstract

Millions of cataract surgeries with intraocular lens (IOL) implantation are performed worldwide. Although cataract surgery brings many benefits to the patients, the risk of various complications is still a concern. One of the infrequent adverse events but potentially affecting on patients’ visual acuity and contrast sensitivity is losing the transparency of IOL. IOL opacification may lead to IOL removal or exchange, which is unpleasant to both the patient and the surgeon. Several reports of acute IOL clouding are available in the literature describing various etiologies of this phenomenon, however, the exact mechanism remained unclear in some cases. Herein, we aimed to review the causes and outcomes of intraoperative and early postoperative IOL opacification.

FIL SSF intraocular lens opacification after gas tamponade: A case series

“…14 Opacification occurred early in our cases as it happened only 2 months after the surgery, although previous descriptions of hydrophilic IOLs found a mean time of opacification around 24 months. 10,13 Severe inflammation and presence of gas in the anterior chamber may have increased the risk and rate of opacification. Some studies suggest that diabetes is a major risk factor for hydrophilic IOL opacification, 15,16 and it should be noted that two of our patients had type 2 diabetes.…”

“…Opacification of hydrophilic IOLs is a well-known complication of hydrophilic IOLs 9,11,12 which are less commonly used nowadays than hydrophobic IOLs due to the higher risk of posterior capsular opacification. 10,13 Nevertheless, only one case has described FIL SSF IOL opacification after DSAEK with multiple air tamponades. 5 To the best of our knowledge, this is the first report of FIL SSF IOL opacification after gas tamponade for pars plana vitrectomy with C2F6 tamponade or DMEK.…”

FIL SSF intraocular lens opacification after pars plana vitrectomy with gas tamponade for traumatic lens luxation and retinal detachment: a case report and literature review

“…According to timing, IOL opacifications can be divided into intraoperative/early postoperative (acute), if they occur in the first month after surgery, and late postoperative if the time interval between IOL implantation and opacification is longer [ 21 ].…”

“…Among causes that have been hypothesized for acute IOL opacification are: consolidation of water vapor and/or change in water content due to temperature fluctuation (causing the so-called IOL clouding), crystallization on IOL surface, secondary to the reaction between Calcium ions of irrigating solutions and phosphate ions of viscosurgical devices, discoloration secondary to intracameral dye, coating by ointments, and postoperative inflammation [ 21 ].…”