A unique late-onset intraocular lens opacification 23 years after implantation: a clinical and laboratory case report

Panos S Gartaganis; Panagiota D Natsi; Sotirios P Gartaganis; Petros G Koutsoukos; Horst Helbig

doi:10.1177/25158414241237713

A unique late-onset intraocular lens opacification 23 years after implantation: a clinical and laboratory case report

Ther Adv Ophthalmol. 2024 Mar 25:16:25158414241237713. doi: 10.1177/25158414241237713. eCollection 2024 Jan-Dec.

Authors

Panos S Gartaganis¹, Panagiota D Natsi², Sotirios P Gartaganis³, Petros G Koutsoukos², Horst Helbig⁴

Affiliations

¹ Department of Ophthalmology, 251 Hellenic Air Force General Hospital, 3 Kanellopoulou Ave., Athens 11525, Greece.
² Laboratory of Inorganic and Analytical Chemistry, Department of Chemical Engineering, University of Patras and FORTH-ICEHT, Patras, Greece.
³ Department of Ophthalmology, School of Medicine, University of Patras, Patras, Greece.
⁴ Department of Ophthalmology, University Hospital of Regensburg, Regensburg, Germany.

Abstract

We report an unusual, rare case of opacification of the hydrophilic acrylic intraocular lens (IOL) 23 years after the initial surgery with significant visual deterioration. Opacification of the hydrophilic acrylic IOL was primarily due to the formation of folds on the surface of the lens material, and less so due to calcium phosphate deposits. Calcification opacification can be attributed to recent events, as evidenced by deposits of dicalcium phosphate dihydrate (CaHPO₄2H₂O) and octacalcium phosphate (Ca₈H₂(PO₄)₆5H₂O), both of which are transient calcium phosphate phases, converting hydrolytically to the thermodynamically most stable hydroxyapatite (Ca₁₀(PO₄)₆(OH)₂). To our knowledge, this case of hydrophilic acrylic IOL opacification is the only one that has been described so late, 23 years after cataract surgery.

Keywords: IOL opacification; calcification; hydrophilic IOL.

Publication types

Case Reports