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Yoon, Kim, and Chin: Late Postoperative Opacification of Multifocal Intraocular Lens after Vitrectomy in a Diabetic Patient
Case Report

Journal of the Korean Ophthalmological Society 2019; 60(12): 1329-1333.

Published online: 17 December 2019

DOI: https://doi.org/10.3341/jkos.2019.60.12.1329

Late Postoperative Opacification of Multifocal Intraocular Lens after Vitrectomy in a Diabetic Patient

Myung Hun Yoon, MD, Se Young Kim, MD, Hee Seung Chin, MD, PhD

Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea.

Address reprint requests to Hee Seung Chin, MD, PhD. Department of Ophthalmology, Inha University Hospital, #27 Inhang-ro, Jung-gu, Incheon 22332, Korea. Tel: 82-32-890-2400, Fax: 82-32-890-2417, hschin@inha.ac.kr

Received 28 June 2019       Revised 25 July 2019       Accepted 6 December 2019

©2019 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report a case of late opacity of an AT LISA intraocular lens after vitrectomy in a diabetic patient.

Case summary

A 61-year-old man presented with blurring in the left eye. He had undergone bilateral phacoemulsification and intraocular lens implantation 6 years ago, and vitrectomy with SF6 gas tamponade in the left eye due to rhegmatogenous retinal detachment 3 years ago. The patient was diagnosed with pre-existing diabetes, hypertension, and coronary heart disease. Examination of the left eye showed round and centrally located whitish fine granular deposits on the surface of the intraocular lens, and zonular rupture from the 3 to 6 o'clock position. The intraocular lens in the right eye was clear. The corrected vision was 0.9 in the right eye and 0.5 in the left eye. The intraocular lens was explanted from the left eye together with the capsular bag, and was examined under light microscopy, histochemical analysis, and with scanning electron microscopy equipped with an energy dispersive X-ray spectroscopy detector with light element capabilities.

Conclusions

This study was the first to report late postoperative opacity in the multifocal intraocular lens, AT LISA 809M. The possibility of intraocular lens opacity in patients with underlying disease or in those undergoing vitrectomy should be explained prior to corrective procedures.

Keywords: Calcification, Intraocular, Lenses

Figures and Tables

Figure 1

Clinical slit lamp photograph of an opacified intraocular lens at the time of presentation. It shows an overall round area of well-circumscribed whitish and fine granular opacification.

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Figure 2

Gross photograph of the explanted intraocular lens showing an overall round area of well-circumscribed whitish and fine granular opacification. The concentric multiple rings shown in the optic are the diffraction patterns of the multifocal intraocular lens.

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Figure 3

Light microscopy photographs of the explanted intraocular lens. Unstained photographs showing the granular depositions on the surface of the intraocular lens. ([A] original magnification, ×40; [B] ×100) The depositions stained positive with alizarin red. ([C] original magnification, ×40; [D] ×100).

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Figure 4

Scanning electron microscopy (SEM) photograph obtained from the explanted lens (A) and control lens (B) (original magnification, ×400). Energy-dispersive X-ray spectrometrum obtained from the surface of the explanted lens (C) and control lens (D). The analysis confirmed the presence of calcium (Ca) and phosphate (P) within the deposits. Au (gold) peak was due to the surface coating using gold to give conductivity to the samples for SEM.

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Notes

Conflicts of Interest The authors have no conflicts to disclose.

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