Calcification in hydrophilic intraocular lenses associated with injection of intraocular gas

Abstract

Purpose: To report a distinct type of calcification in hydrophilic intraocular lenses in complicated, traumatized eyes with a history of intraocular gas use.

Design: Observational case series.

Methods: Three cases of hydrophilic intraocular lens (IOL) opacification confined to the pupillary area are reported from clinical practice in London, UK. Clinical details and analysis of the explanted intraocular lenses are provided with environmental scanning electron microscopy images and x-ray energy-dispersive spectroscopy results.

Results: All cases were associated with use of intraocular gas in complicated traumatized eyes, and had central areas of IOL opacification over the pupillary zone, confined to the anterior surface of the IOL. Analysis of the lenses showed the opacified areas to be composed of calcium and phosphate.

Conclusion: The areas of opacification in all 3 hydrophilic IOLs were attributable to calcification. We postulate that intraocular gas use and the altered blood-aqueous barrier of these complicated traumatized eyes co-act to trigger secondary IOL calcification. Further experimental testing is needed to confirm this clinical association.