Ultrastructural evaluation of explanted opacified Hydroview (H60M) intraocular lenses.

AIM: To describe the ultrastructural appearance of explanted opacified Hydroview H60M intraocular lenses. METHODS: 14 explanted lenses were examined by scanning electron microscopy, and their appearance compared with a non-implanted H60M lens from the same time period. Wavelength-dispersive x ray spectroscopy (WDX) was performed on two opacified lenses. RESULTS: Subsurface deposits were seen in all explanted opacified lenses. These deposits broke only onto the surface of more densely opacified lenses. WDX confirmed that the deposits contained both calcium and phosphorous, consistent with their being calcium apatite. CONCLUSION: These findings challenge the widely accepted opinion that H60M intraocular lens opacification begins on the surface of the optic.

Calcification of hydrophilic acrylic intraocular lenses in combined phacovitrectomy surgery.

UNLABELLED: Two cases of postoperative intraocular lens (IOL) calcification in patients implanted with the Akreos Adapt IOL at the time of combined phacovitrectomy are described, along with clinical review of all patients implanted with this IOL type at our institution between November 2006 and September 2008. The IOLs explanted from the 2 cases were examined using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). The SEM of the explanted IOLs showed crystalline anterior surface and subsurface deposits; by EDX, the deposits showed high concentrations of calcium and phosphorous, consistent with calcium apatite. Twenty patients (20 eyes) attended for cohort review, and none showed IOL opacification. The reason calcification occurred in the 2 cases remains unknown, but clinicians should be aware of this potential complication. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.