Postoperative surface deposits on intraocular lenses in children
Accepted 20 June 2006.
Purpose
To report the clinicopathologic features of 4 intraocular lenses (IOLs) composed of 3 different hydrophilic biomaterials explanted from children who had postoperative opacification of the IOL optic.
Setting
David J Apple, MD, Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA.
Methods
The IOLs were explanted 20, 11, 22, and 25 months postoperatively from children aged 10, 3, 36, and 20 months old, respectively, at IOL implantation. Clinical data were obtained to correlate the findings with possible associated risk factors. The explanted IOLs were examined by gross and light microscopy. They were further analyzed with a stain for calcium, alizarin red 1%. Scanning electron microscopy and energy dispersive X-ray spectroscopy (EDS) were also performed.
Results
The primary reason for cataract surgery in Case 1 and Case 2 was persistent hyperplastic primary vitreous (PHPV); 1 patient received a B-Lens IOL (Hanita) and the other a Centerflex IOL (Rayner). The primary reason in Case 3 was familial bilateral congenital cataract and in Case 4, rubella cataract; both patients received a Hydroview IOL (Bausch & Lomb). All 4 IOLs had surface deposits on the optic, but the morphology of the deposits on the B-Lens and Centerflex IOLs was different than that in previously reported cases. The deposits in all four cases stained positive with alizarin red and consisted of calcium and phosphorus when imaged with EDS.
Conclusions
Calcified deposits on 2 Hydroview IOLs explanted from children were similar to those seen in adults with the same IOL. The deposits on the B-Lens and Centerflex IOLs were probably secondary to a breakdown of the blood–aqueous barrier caused by preexisting PHPV.
From the David J. Apple, MD, Laboratories for Ophthalmic Devices Research (Kleinmann, Apple, Werner, Pandey, Neuhann, Mamalis), John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA; University Eye Hospital Tuebingen (Neuhann), Tuebingen, Germany; and the Departments of Ophthalmology (Assia), Meir Hospital, Sapir Medical Center, Kfar-Saba, Israel, Singleton Hospital (Laws, de Borin), Swansea, England, and Department of Ophthalmology, Maracaibo University Hospital (de Borin), Maracaibo, Venezuela
Corresponding author: Guy Kleinmann, MD, John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, 50 North Medical Drive, Salt Lake City, Utah 84132, USA.
Presented in part at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, San Diego, California, USA, May 2004.
Supported by the Research to Prevent Blindness Olga Keith Wiess Scholar Award (Dr. Werner).
Dr. Apple is a consultant to Alcon, AMO, Hoya, and Rayner. Dr. Assia is a consultant to Hanita, Israel. No other author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT