Late green discoloration of Allergan SI-40NB silicone intraocular lens

Purpose:We report the clinicopathological features and surgical outcomes of two cases of intraocular lens (IOL) calcification along with a review of the current literature.Case Report:The first patient was a 53-year-old woman with diabetes mellitus (type 2) who underwent phacoemulsification with posterior chamber IOL insertion (PCIOL), and pars plana vitrectomy. Significant clouding of the IOL was first noted after 1.5 years, and the IOL was replaced with an Artisan lens. The second patient was a 22-year-old woman with Vogt-Koyanagi-Harada syndrome; she underwent a lensectomy, PCIOL, and pars plana vitrectomy. IOL opacification was first noted 4.5 years after the initial surgery and the IOL was extracted.Conclusion:The calcification of each IOL was confirmed by a pathologist. Further studies are required to determine the primary causes and mechanisms of the calcification of biomaterials including IOLs.

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“…Therefore, these IOLs are replaced due to reasons unrelated to opacity, such as disability, lack of concentration, or trauma. [ 11 15 16 17 18 ]…”

Section: Discussionmentioning

confidence: 99%

Intraocular lens calcification: Clinico-pathological report of two cases and literature review

Rahimi

Azimi

Hosseinzadeh

2018

J Ophthalmic Vis Res

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“…Sathyan et al 63 reported a non-progressive green discolouration in a silicone IOL (Allergan SI-40NB, USA). This was documented 6 months after surgery in two patients.…”

Section: Postoperative Degradation/opacification Of Silicone Iolsmentioning

confidence: 99%

Clinical and material degradations of intraocular lenses: A review

Stanojcic

Hull

O’Brart

2019

European Journal of Ophthalmology

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Purpose:To review the published scientific literature concerning clinical and material degradations of intraocular lenses after implantation in cataract surgery.Methods:A search was undertaken using the following databases: CENTRAL (including Cochrane Eyes and Vision Trials Register; The Cochrane Library: Issue 2 of 12 February 2019), Ovid MEDLINE (R) without Revisions (1996 to February week 2, 2019), Ovid MEDLINE (R) (1946 to February week 2, 2019), Ovid MEDLINE (R) Daily Update 19 February 2019, MEDLINE and MEDLINE non-indexed items, Embase (1980–2019, week 7), Embase (1974–2019, 19 February), Ovid MEDLINE (R) and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to 19 February 2019), Web of Science (all years), the metaRegister of Controlled Trials ( mRCT) ( www.controlled-trials.com ), ClinicalTrials.gov ( www.clinicaltrial.gov ) and the WHO International Clinical Trials Registry Platform ( www.who.int/ictrp/search/en ). Only published articles in English were selected. Search terms/keywords included ‘IOL’ or ‘intraocular lens’, combined with ‘opacification’, degradation, glistenings, nanoglistenings, whitening, transmittance, light scatter, discolouration/discoloration, performance, quality, material, biocompatibility, calcification, explantation and ultraviolet/UV radiation. Relevant in-article references not returned in our searches were also considered.Results:After review of the available articles, the authors included 122 publications in this review, based on the quality of their methodology and their originality. The studies included in this review were randomized controlled trials, cohort studies, case-controlled studies, case series, case reports, laboratory studies and review papers. Differing material degradations of intraocular lenses have been described and their associated pathophysiology studied. Reported anomalies include photochemical alterations, water vacuoles, internal and surface calcific deposits, surface coatings and discolouration. The nature of such changes has been shown to depend on the type of intraocular lenses material used and/or manufacturing processes and storage conditions employed. Changes in the intraocular lens can also be influenced by surgical technique, coexisting ocular pathologies and topical and systemic medications. The clinical significance of these degradations is variable, with some resulting in significant visual disturbance and the need for intraocular lens explantation and others producing only minimal visual impairments. Failure to recognize the precise nature of the problem may lead to unnecessary laser capsulotomy procedures.Conclusion:Clinical degradations of intraocular lenses are uncommon but have been reported following the implantation of intraocular lenses made of differing biomaterials. Their correct identification and thorough investigation to determine the underlying cause is necessary for optimal patient management and the prevention of such problems. Choosing a lens made of a particular material may be important in patients with certain ocular conditions.

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“…Since then, there have been other reports of brown, blue, 3 and green discolouration. 4 Most have been case reports and mainly of silicone IOLs. There were no reports of major visual problems or IOL explantations.…”

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confidence: 99%