Ungewöhnliche Kalzifikation intraokularer Kunstlinsen nach vitreoretinalem Eingriff mit Silikonölendotamponade

Chronopoulos, Argyrios; Varga, Zsolt; Steinfeld, P. A.; Dahlmann, Rainer; Jukić, Tomislav; Walter, Peter; Thumann, Gabriele

doi:10.1055/s-0034-1383230

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…There are very few cases published reporting IOL calcification after PPV with silicone oil tamponade [16][17][18]. In the majority of them, IOL opacification occurred after silicone oil removal.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical inflammation caused by vitrectomy, retinopexy and tamponade agents leads to a breakdown of the blood-aqueous barrier to some extent in all eyes. Most cases of IOL calcification after PPV were reported to have previous combined phacoemulsification and vitrectomy [9,[16][17][18]34,35]. Even if clinically not relevant, combined phacoemulsification and vitrectomy is accompanied by more postoperative inflammation compared to vitrectomy alone [35].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics of Patients with Intraocular Lens Calcification after Pars Plana Vitrectomy

et al. 2023

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Aim: To determine the clinical risk factors that may increase the occurrence of intraocular lens (IOL) calcification in patients who had undergone pars plana vitrectomy (PPV). Methods: The medical records of 14 patients who underwent IOL explantation due to clinically significant IOL opacification after PPV were reviewed. The date of primary cataract surgery, technique and implanted IOL characteristics; the time, cause and technique of PPV; tamponade used; additional surgeries; the time of IOL calcification and explantation; and IOL explantation technique were investigated. Results: PPV had been performed as a combined procedure with cataract surgery in eight eyes and solely in six pseudophakic eyes. The IOL material was hydrophilic in six eyes, hydrophilic with a hydrophobic surface in seven eyes and undetermined in one eye. The endotamponades used during primary PPV were C2F6 in eight eyes, C3F8 in one eye, air in two eyes and silicone oil in three eyes. Two of three eyes underwent subsequent silicone oil removal and gas tamponade exchange. Gas in the anterior chamber was detected in six eyes after PPV or silicone oil removal. The mean interval between PPV and IOL opacification was 20.5 ± 18.6 months. The mean BCVA in logMAR was 0.43 ± 0.42 after PPV, which significantly decreased to 0.67 ± 0.68 before IOL explantation for IOL opacification (p = 0.007) and increased to 0.48 ± 0.59 after the IOL exchange (p = 0.015). Conclusions: PPV with endotamponades in pseudophakic eyes, particularly gas, seems to increase the risk for secondary IOL calcification, especially in hydrophilic IOLs. IOL exchange seems to solve this problem when clinically significant vision loss occurs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Patients with Intraocular Lens Calcification after Pars Plana Vitrectomy

et al. 2023

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“…Silicone oil has been reported as an exogenous nucleation source of dystrophic calcification in hydrophilic lenses, either as a complication of silicone oil tamponade 16 , 17 or as a contaminant in ophthalmic viscosurgical devices. 18 , 19 Hydrophilic IOLs demonstrate less tendency towards silicone oil adherence compared to hydrophobic designs.…”

Section: Discussionmentioning

confidence: 99%

Intraocular lens dystrophic calcification after trans-scleral diode laser treatment for a cyclodialysis cleft

Abdul-Rahman

House

Richards

2018

American Journal of Ophthalmology Case Reports

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PurposeTo describe a case of intraocular lens (IOL) dystrophic calcification as a complication of trans-scleral diode laser successfully used to treat a post-trabeculectomy cyclodialysis cleft.ObservationsA 76-year-old male with primary open angle glaucoma and pseudophakia (+19.0D Akreos M160L, Bausch & Lomb) was evaluated for vision impairment 4 months post-trabeculectomy complicated by a cyclodialysis cleft of his right eye. The patient was successfully treated with trans-scleral diode laser. After this treatment IOL opacification developed. Slit lamp examination and color photography of the anterior segment was performed prior to exchange of the opacified IOL. The explanted IOL underwent star testing, macroscopic imaging, phase contrast and scanning electron microscopy in addition to energy dispersive x-ray spectroscopy.Confluent IOL deposits developed 4 months after trans-scleral diode laser treatment requiring IOL exchange. Star optical testing of the explanted IOL showed disruption of the diffraction image. An asymmetric pattern of deposition was congruent with the laser treatment quadrant. The subsurface location and discrete nature of the deposits were seen on phase contrast and electron microscopy. Energy dispersive x-ray spectroscopy demonstrated a predominance of calcium/phosphate in the deposits. We are unaware of previous reports in the literature of IOL dystrophic calcification occurring as a complication of trans-scleral diode laser treatment for a post-trabeculectomy cyclodialysis cleft.Conclusion and importanceDelayed postoperative IOL dystrophic calcification in our case may have been from a combination of IOL biomaterial susceptibility to diode laser energy; damaged IOL material providing a nidus for calcific nucleation; and blood ocular barrier breakdown altering aqueous composition. We suggest that pseudophakia should influence the consideration of diode laser as treatment of a cyclodialysis cleft.

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Ablagerungen auf der Kunstlinsenvorderfläche nach Ölchirurgie

et al. 2015

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Ungewöhnliche Kalzifikation intraokularer Kunstlinsen nach vitreoretinalem Eingriff mit Silikonölendotamponade

Cited by 4 publications

References 18 publications

Clinical Characteristics of Patients with Intraocular Lens Calcification after Pars Plana Vitrectomy

Clinical Characteristics of Patients with Intraocular Lens Calcification after Pars Plana Vitrectomy

Intraocular lens dystrophic calcification after trans-scleral diode laser treatment for a cyclodialysis cleft

Ablagerungen auf der Kunstlinsenvorderfläche nach Ölchirurgie

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