Pathology of intraocular lenses in 33 eyes examined postmortem

Abstract

Thirty-three pseudophakic eyes from 29 patients were examined postmortem. Clinically, 25 of the eyes had had visual acuities of 20/50 or better. In general the intraocular lenses (IOLs) were quite well tolerated. Iris atrophy and erosion were prominent features of eyes containing an anterior chamber, iris fixation, or iridocapsular lens. Angle recession and ciliary-body erosion were found in some eyes with anterior chamber lenses. Ciliary-body erosion by haptics was seen with posterior chamber lenses. Pupillary membranes were present in eight eyes. Granulomatous reaction to IOL material was present in 13 eyes. Usually this was localized to the site of the lens haptic, and was consistent with good visual acuity. One eye with a posterior chamber lens had been successfully treated for Staphylococcus epidermidis endophthalmitis after capsulotomy, shortly before death. Central corneal endothelial cell loss seemed to be of similar amount for the anterior chamber, iris fixation, and iridocapsular lenses, but was less severe in eyes with posterior chamber lenses. Cystoid macular edema was present in five eyes, retinal phlebitis in two eyes, and retinal detachments in four eyes.