Purpose

To describe the clinical and laboratory findings in a series of cases of hydrophilic acrylic intraocular lens (IOL) opacification after posterior segment procedures.

Setting

John A. Moran Eye Center, University of Utah, Salt Lake City, USA.

Design

Experimental study.

Methods

Thirty hydrophilic acrylic IOLs were explanted after various posterior segment procedures (pars plana vitrectomy, intravitreal anti-vascular endothelial growth factor injections) because of localized central anterior surface and subsurface optic opacification associated with decreased visual function. Once received by the laboratory in the dry state or in fixative by the explanting surgeons, microscopic, histochemical (alizarin red), and surface analysis (scanning electron microscopy [SEM], energy-dispersive X-ray spectroscopy [EDS]) evaluations were performed on the IOLs. The surgeons were sent a questionnaire to obtain information pertinent to each case.

Results

Of the 30 explanted IOLs, 9 hydrophilic acrylic designs from 7 different manufacturers were identified. Gross microscopy and light microscopy showed granular deposits in a dense round pattern of distribution within the margins of the capsulorhexis or pupil on the anterior surface/subsurface of the IOLs. The granules stained positive for calcium with alizarin red. On SEM coupled with EDS, the granular deposits were found to comprise calcium and phosphate.

Conclusions

A localized pattern of anterior surface/subsurface calcification was seen on hydrophilic acrylic IOLs from various manufacturers. The calcification resembled the pattern seen on calcified IOLs after anterior segment procedures using intracameral injections of air or gas. This calcification of hydrophilic acrylic IOLs is likely the result of blood–aqueous barrier breakdown from repeated intraocular procedures.

中文翻译：

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后段手术后亲水性丙烯酸人工晶状体的局部钙化

目的

描述后路手术后一系列亲水性丙烯酸人工晶状体（IOL）混浊病例的临床和实验室发现。

设置

美国盐湖城犹他大学John A.Moran眼科中心。

设计

实验研究。

方法

由于局部中央前表面和表面下视神经混浊与视觉功能下降有关，因此在各种后段手术（pars平面玻璃体切除术，玻璃体内抗血管内皮生长因子注射）后植入了30种亲水性丙烯酸IOL。一旦实验室以干燥状态或外植固定剂接受固定剂，则进行显微镜，组织化学（茜素红）和表面分析（扫描电子显微镜[SEM]，能量色散X射线光谱[EDS]）评估在IOL上。向外科医生发送了问卷，以获取与每个案例有关的信息。

结果

在30种植入的IOL中，确定了来自7个不同制造商的9种亲水性丙烯酸设计。大体显微镜检查和光学显微镜检查显示，在人工晶状体前表面/亚表面的撕囊或瞳孔的边缘分布有密集的圆形分布的颗粒状沉积物。用茜素红将颗粒染色为阳性。在结合EDS的SEM上，发现颗粒状沉积物包含钙和磷酸盐。

结论

在来自不同制造商的亲水丙烯酸IOL上看到了前表面/亚表面钙化的局部模式。钙化类似于使用前房内注射空气或气体进行前节手术后在钙化IOL上看到的模式。亲水性丙烯酸IOL的这种钙化可能是反复眼内手术导致血水屏障破坏的结果。