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Cataract development associated with collagen copolymer posterior chamber phakic intraocular lenses:
Yousuf M Khalifa1, Majid Moshirfar, Mark D Mifflin
1Flaum Eye Institute, University of Rochester, Rochester, New York, USA.
Purpose:
To assess the histopathology of anterior subcapsular cataract associated with a collagen copolymer posterior chamber phakic intraocular lens (pIOL) (Visian Implantable Collamer Lens) using light microscopy after pIOL explantation and cataract surgery.
Setting:
John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
Design:
Laboratory investigation.
Methods:
Pathology specimens related to explanted pIOLs were reviewed and preoperative and postoperative patient data collected. The anterior lens capsules and explanted pIOLs were examined.
Results:
Four eyes (3 patients) had pIOL explantation for low vault and anterior subcapsular cataract. The explanted pIOLs were the shorter length models (3, 12.1 mm; 1, 12.6 mm). Anterior segment optical coherence tomography (AS-OCT) confirmed the low pIOL vault before explantation in 2 eyes. Histopathology of the anterior subcapsular cataract showed fibrous metaplasia with a variable number of lens epithelial cell (LEC) layers attached to the inner surface of the anterior capsulorhexis specimens. Light microscopy of the explanted pIOLs showed no pigment on 1 lens, mild pigment deposition on 1 haptic, and pigment deposition throughout the anterior surface of 2 pIOLs.
Conclusions:
Anterior subcapsular cataract associated with the pIOLs was caused by low vaulting (confirmed on AS-OCT) and consequent fibrous metaplasia of the anterior LECs. Surgeons should consider the possibility of anterior subcapsular cataract associated with shorter platforms when selecting a pIOL length for appropriate vault.
