Brown deposits in the optic of foldable intraocular lenses in patients with uveitis

To report a new finding of brown deposits scattered in the substance of the optic of foldable intraocular lenses (IOL) following phakoemulsification in patients with uveitis.

Consecutive uveitis patients (54 patients, 71 eyes) who had undergone phakoemulsification with a foldable posterior chamber IOL between March 1996 and November 2000 were studied. A variety of biomaterials from seven different manufacturers had been implanted. One masked observer using slit-lamp biomicroscopy assessed deposits in the substance of the optic of the IOL.

Brown deposits were detected in the substance of the optic of 25/71 (35%) IOLs with 18/22 (82%) of AcrySof MA60BM IOLs being affected. Using logistic regression analysis, the AcrySof MA60BM IOL was significantly associated with the presence of deposits (adjusted odds ratio=38.5, 95% CI 6.9-200, P<0.001). Using multiple regression analysis, there was a significant association between the severity of deposits and the use of the AcrySof MA60BM IOL (P=0.005). Compared with other foldable IOLs implanted, the AcrySof MA60BM IOL was 38.5 times more likely to develop intra-IOL deposits. There was no association with those eyes that had undergone increased intraocular manipulations. The deposits did not appear to affect visual acuity.

To our knowledge the finding of brown intra-IOL deposits has not previously been described. These deposits are more frequent in the AcrySof MA60BM implant than the other foldable implants studied. They share some similarities with glistenings, but their exact nature remains unknown.