Postoperative intraocular lens opacification

Abstract

Intraocular lens (IOL) opacification is rare but may occur after non-Descemet stripping automated endothelial keratoplasty (n-DSAEK) or intravitreal air injection after pars plana vitrectomy (PPV). We reported two cases of IOL opacification within the pupillary region. Chart was retrospectively reviewed. The predisposing factors and the visual acuity were analyzed. The opacification was evaluated by anterior segment optical coherence tomography (AS-OCT). A 68-year-old healthy woman with pseudophakic bullous keratopathy underwent uneventful n-DSAEK in the right eye. Postoperative vision was 20/40. Nine months after surgery, fine granular deposits were seen in the anterior surface of IOL. The vision decreased to 20/50 but remained stable during 3-year follow-up. A 61-year-old man with diabetes mellitus received PPV and silicone oil tamponade for retinal detachment and vitreal hemorrhage after cataract surgery in the right eye. Removal of silicone oil and intravitreal air injection was performed, and postoperative vision was 20/100. Granular deposits were observed in hydrophobic acrylic IOL 1 month after surgery. The visual acuity decreased to 20/120. AS-OCT revealed hyperreflective materials in the anterior surface of IOL in both cases. An uncommon phenomenon of IOL opacification in the pupil region may occur after n-DSAEK or PPV, which may be associated with intraocular air injection or systemic diseases.

Keywords: Intraocular air injection; intraocular lens; non-Descemet stripping automated endothelial keratoplasty; opacification.

Figure 1

External eye photography. Fine granular deposits occurred in the anterior surface of the intraocular lens within the pupillary region 9 months after non-Descemet stripping automated endothelial keratoplasty in case 1 (a) and 1 month after intravitreal air injection in case 2 (b)

Figure 2

Anterior segment optical coherence tomography. In spite of the hyperreflective signal can be observed between different media in anterior segment optical coherence tomography image, the signal is more intense in the anterior surface of the Intraocular lens in the pupillary area, which indicated the area of material deposition in case 1(a) and case 2 (b)