Localized opacification of hydrophilic acrylic intraocular lenses after procedures using intracameral injection of air or gas

Abstract

No author has a financial or proprietary interest in any material or method mentioned.

Microscopic analysis of an opacified OFT CRYL® hydrophilic acrylic intraocular lens

“…This was our first case of opacification. Thus, this IOL should not be discredited based on the current report, which supports the hypothesis that intracameral gas can act as a trigger of hydrophilic lens calcification (2)(3)(4)(5)(6)(7)(8)(9) . Together with previous articles (2)(3)(4)(5)(6)(7)(8)(9) , the present report suggests that hydrophilic IOLs should be avoided in eyes that require procedures associated with intracameral presence of air or gas.…”

“…Similarly to the pattern seen in the Oft Cryl® IOL, calcification within the pupillary and anterior capsulorrhexis margins has been described in eyes in which gas or air 1) was injected intracamerally to treat Descemet's membrane detachment, to aid in graft adherence in endothelial transplants; 2) was injected to treat hypotony following trabeculoplasty; or 3) went into the anterior chamber after injection in the vitreous cavity to treat retinal detachment and ocular hypotony (2)(3)(4)(5)(6)(7)(8) . In these lenses, calcium granules were also found on the surface and subsurface of the IOLs.…”

“…Previous papers have described cases of IOL opacification in hydrophilic acrylic IOLs from different manufacturers (2)(3)(4)(5)(6)(7)(8)(9)(10)(11) . However, to the best of our knowledge, this is the first peer-reviewed report on Oft Cryl® IOL opacification.…”

“…Werner et al (2) proposed three possible explanations for IOL calcification after procedures involving intracameral air or gas: 1) direct contact between the IOL surface and the exogenous gas/substance; 2) intracameral metabolic change because of the presence of an exogenous gas/substance; and 3) exacerbated inflammatory reaction after multiple surgical procedures. The formation of calcium deposits appears to depend both on the material of the IOL and on the local chemical microenvironment of the aqueous humor (12) .…”

“…Recently, opacification associated with the presence of gas or air in the anterior chamber has been reported (2)(3)(4)(5)(6)(7)(8)(9) . Since 2005, the single-piece hydrophilic acrylic Oft Cryl® IOL (Oft Vision, São Paulo, Brazil) has been largely used in Brazil; however, no case of lens opacification has been reported in the peer-reviewed scientific literature.…”