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Intraocular Lens Opacification After Endothelial Keratoplasty as Analyzed by Environmental Scanning Electron
Paula Verdaguer1, Oscar Gris, Ricardo P Casaroli-Marano
1*Department of Cornea and Refractive Surgery, Instituto de Microcirugía Ocular (IMO), Barcelona, Spain; †Universitat Autònoma de Barcelona, Barcelona, Spain; and ‡Department of Surgery, School of Medicine & Hospital Clínic de Barcelona (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
Purpose:
To describe a case of hydrophilic intraocular lens (IOL) opacification based on IOL analysis after Descemet stripping automated endothelial keratoplasty.
Methods:
A 60-year-old woman had uneventful phacoemulsification after the implantation of a hydrophilic IOL (Akreos-Adapt; Bausch & Lomb) into both eyes. Because of postoperative corneal decompensation in the right eye, 2 Descemet stripping automated endothelial keratoplasty operations were performed within 1 year. After the second procedure, the graft was not well attached, requiring an intracameral injection of air on day 3. After 1 year, opacification was observed on the superior 2/3 of the anterior surface of the IOL, along with a significant decrease in visual acuity. The IOL was explanted 6 months after the opacification.
Results:
Environmental scanning electron microscopy followed by x-ray microanalysis revealed an organic biofilm on the surface of the IOL.
Conclusions:
To our knowledge, this is the first reported case in which the material deposited on the lens is organic rather than calcific.
