Postoperative deposition of calcium on the surfaces of a hydrogel intraocular lens

Abstract

Objective: To report clinical, pathological and histochemical features of 5 Hydroview intraocular lenses (IOLs) explanted from five patients who had visual disturbances caused by postoperative deposits on the lens surfaces.

Design: Noncomparative small case series with clinicopathologic and histochemical correlations.

Participants: Five hydrophilic IOLs explanted from five different patients. All patients presented with decreased visual acuity and glare circa 12 months after uneventful phacoemulsification and IOL implantation, associated with a red-brown granularity on the optical surfaces of the IOLs.

Methods: The lenses were explanted, fixed in buffered formaldehyde and examined by gross and light microscopy.

Main outcome measures: Staining of the IOLs with 1% alizarin red and with the von Kossa method (both stains for calcium). Two additional IOLs were also stained and included as controls.

Results: The optical surfaces of all five IOLs were covered by a layer of irregular granular deposits, composed of multiple fine, translucent spherical-ovoid granules. The deposits stained positive for calcium in all cases. No deposit or positive staining was observed on the IOLs haptics. Staining of the control IOLs was also negative.

Conclusion: This is the first histopathological report of calcified deposits on the surfaces of this hydrogel IOL model. Further studies on other similar cases with this lens should be done to determine the incidence and possible mechanisms of this phenomenon.