[Intraocular inflammatory reactions following implantation of a retropupillary lens]

The implantation of an artificial lens into the retropupillary space, be it the sulcus ciliaris or the capsular bag, has proved to be a safe procedure in the vast majority of cases. However, posterior chamber lens implantation invariable provokes some intraocular inflammatory reaction, though in general only a clinically insignificant one. Occasionally, serious reactions may occur, such as fibrinous exsudates, "toxic lens syndrome", UGH syndrome, and the "intermittent white-out" syndrome. Lens-induced, IOL-induced, or even microbe-induced uveitis or endophthalmitis have also been seen. The clinical pictures of such complications are described. Prophylaxis and appropriate therapeutic measures are outlined. With regard to postoperative inflammatory reactions whose etiology is unclear, the potential role of the following factors is discussed: lens material, lens manufacturing technology, sterilization, and sulcus fixation vs. capsule fixation. Presently, there is no evidence of any obvious relationship between these factors and major inflammatory responses. However, patients suffering from glaucoma, diabetes, or uveitis seem to be more prone to significant postoperative reactions than others. Generally, in cases of unusual intraocular inflammation following posterior chamber lens implantation, the various clinical pictures described here should be taken into consideration. The possibility of a slowly developing microbe-induced endophthalmitis should not be overlooked.