Acute clouding of a trifocal intraocular lens with spontaneous resolution: a case report

Opacification of hydrophobic and hydrophilic intraocular lenses (IOLs) has been reported. Herein, we report a case of spontaneous resolution of opacification following acute clouding of a trifocal IOL, which consisted of hydrophilic acrylic material (25%) with hydrophobic surface properties, occurring in a cold region in the winter season.

A young adult with bilateral radiation cataract underwent phacoemulsification using a femtosecond laser and implantation of a trifocal IOL. The trifocal IOL was delivered to the operating theatre 30 min before the surgery. The outside temperature was approximately - 7 °C. The IOL package was warmed using a radiator at approximately 35 °C for 15 min. After the optical region was implanted in the eye, cloudiness was observed, which persisted throughout the operation. Complete clearing of the IOL was apparent after three postoperative hours.

In this case, rapid opacification and clearing of the IOL suggested an acute and transient process. IOLs should be stored and shipped at a constant temperature, and sudden temperature fluctuations should be avoided, especially in the colder seasons.