Surface deposits mimicking calcification on a hydrophobic acrylic intraocular lens

We describe the case of a female patient who had 3-piece silicone intraocular lenses (IOLs) bilaterally implanted after uneventful surgeries in 2007. Nine years later, the IOLs were explanted and exchanged with 3-piece hydrophobic acrylic IOLs because of cloudiness on their posterior aspect. Two years later, a similar finding was observed on the hydrophobic acrylic IOLs, and it was more intense in the left eye. The IOL in this eye was explanted and submitted for microscopic evaluation, which demonstrated the presence of multiple deposits irregular in shape and size covering significant areas of anterior and posterior optic surfaces. Elemental analyses ruled out the presence of calcification. The surface deposits stained positive for proteins. To our knowledge, postoperative calcification has not been definitively associated with hydrophobic acrylic IOLs to date.