ArticleDer Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft2017
[Opacification of a hydrophilic acrylic intraocular lens after DMEK : A material analysis].
Article in Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 27 citations in OpenAlex.
- Development of a standardized in vitro model to reproduce hydrophilic acrylic intraocular lens calcification.Scientific reports · 2022Article
- [Material properties of intraocular lenses: are there patient-relevant differences?]Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2021Article
- Effects of uncomplicated Descemet membrane endothelial keratoplasty on the central retinal thickness.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2021Article
- Visualization of Forward Light Scatter in Opacified Intraocular Lenses and Straylight Assessment.Diagnostics (Basel, Switzerland) · 2021Article
- A narrative review of intraocular lens opacifications: update 2020.Annals of translational medicine · 2020Review
- [Opacification of hydrophilic intraocular lens after multiple injections of bevacizumab].Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2019Article
- Hydrophilic intraocular lens opacification after posterior lamellar keratoplasty - a material analysis with special reference to optical quality assessment.BMC ophthalmology · 2017Article
- Phakic anterior chamber intraocular lens removal with simultaneous posterior chamber phakic intraocular lens implantation and Descemet membrane endothelial keratoplasty.Taiwan journal of ophthalmologyArticle
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Authors and funding
7 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveCalcification of a hydrophilic intraocular lens (IOL) is a rare complication. We report on the analysis of an opacified IOL, which was explanted 2 years after Descemet membrane endothelial keratoplasty (DMEK), using light and scanning electron microscopy, X‑ray spectroscopy and investigations on the optical bench.
methodsIn October 2012 a patient with pseudophakic keratopathy and Fuchs endothelial dystrophy underwent DMEK with double rebubbling. Due to primary graft failure the patient underwent penetrating keratoplasty in January 2013. The initial postoperative visual acuity was 0.2. Increasing opacification of the IOL lowered visual acuity down to hand movement, so that in November 2014 the patient underwent IOL replacement. The explanted IOL was first natively examined with an Olympus BX50 light microscope. In addition, image quality was determined on the optical bench. Subsequently, the explanted IOL was divided into two and one half was stained with Alizarin red and von Kossa and examined by light microscopy and the other half was analyzed by scanning electron microscopy. The composition of the deposits was examined by X‑ray spectroscopy.
resultsThe macroscopic view showed opacification of the IOL only in the central area of the lens where contact between the IOL and the gas bubble had taken place. Light and scanning electron microscopy revealed numerous fine granular, crystal-like deposits under the anterior IOL surface, which were linearly arranged parallel to the surface. Using energy dispersive X‑ray spectroscopy the deposits were shown to be composed of calcium phosphate. No deposits were detected on the posterior surface.
conclusionThe cause of the opacification of hydrophilic IOL is not clearly understood; however, the injection of gas/air into the anterior chamber during DMEK appears to increase the risk of IOL opacification by changing the lens surface or by alterations to the blood-aqueous humor barrier. Granular deposits under the anterior IOL surface can cause such a strong decrease in visual acuity that IOL exchange becomes neccessary.
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