Causes of intraocular lens opacification or discoloration

Various pathologic processes may lead to clinically significant opacification or discoloration of the optic component of intraocular lenses (IOLs) manufactured from different biomaterials and in different designs. Factors such as the patient's associated conditions, the manufacturing process, the method of IOL storage, the surgical technique and adjuvants, or a combination of these may be involved. The complication may be observed intraoperatively or postoperatively from a few hours after implantation to many years after surgery, depending on the processes involved. Based on a review of the literature as well as our own laboratory analyses, the following types of processes were identified: formation of deposits/precipitates on the IOL surface or within the IOL substance; opacification by excess influx of water in hydrophobic materials; direct discoloration by capsular dyes or medications; coating by substances such as ophthalmic ointment and silicone oil; and a slow, progressive degradation of the IOL biomaterial.