Hydrophilic Intraocular Lens Opacification � A Case Report

Purpose : To report a case of late opacification of the hydrophilic acrylic Intraocular Lens (IOL) after uneventful Cataract Surgery. Methods : A 60-year-old male presented with chief complaint of gradual diminution of vision in right eye over the past one year. He was Normotensive, Non-diabetic and had a normal Lipid Profile. History revealed that he underwent uneventful phacoemulsification with posterior chamber hydrophilic intraocular in the bag implantation for pre-senile cataract in his Right Eye ten years ago. He had the best corrected visual acuity of 6/6 in his Right Eye for nine years Post Cataract Surgery. Slit-lamp examination confirmed Intraocular Lens Opacification. Results : Intraocular Lens exchange was performed in his Right Eye. The hydrophilic IOL was replaced with poly methyl methacrylate intraocular lens. The explanted IOL showed uniform grayish-white opacification. Post operative period was uneventful. Intraocular pressure by applanation tonometry was 16.4 mm Hg in both the eyes. Patient抯 best corrected visual acuity was 6/6 with -1 D Cyl. at 90 degree, Postoperatively. Over a follow up period of one year, the patient did not develop complications like posterior capsular IOL opacification. Conclusion: Intraocular Lens opacification is an extremely rare late postoperative complication of Phacoemulsification which can be managed effectively by IOL exchange procedure in cases of opacified IOL optics causing visual morbidity

Comparison of Nd:YAG Capsulotomy Rates between Hydrophobic and Hydrophilic Intraocular Lenses

PURPOSE: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between hydrophobic and hydrophilic intraocular lenses. METHODS: The present retrospective study enrolled patients who received cataract surgery from a single surgeon between July 2006 to December 2009. Patients included in the study were implanted with SA60AT hydrophobic spherical intraocular lenses (Alcon, Fort Worth, TX, USA, 268 eyes) or I-FLEX hydrophilic spheric intraocular lenses (i-Medical®, Ophthalmic International Heidelberg GmbH, Mannheim, Germany, 331 eyes). The Nd:YAG capsulotomy rates and best-corrected visual acuity (BCVA) were compared between the two groups for 2 years after the operation. RESULTS: The mean follow-up period was 23.5 months and 22.6 months and the mean age was 68.6 years and 70.3 years in the SA60AT and I-FLEX groups, respectively. Follow-up periods were longer in the SA60AT group (p = 0.035), but ages were not significantly different between the two groups (p = 0.367). Nd:YAG laser capsulotomy rates were 6.3% in the SA60AT group and 11.2% in the I-FLEX group. Nd:YAG laser capsulotomy rates were significantly higher in the I-FLEX group (p = 0.020). BCVA before and after the Nd:YAG laser capsulotomy was not significantly different. CONCLUSIONS: Nd:YAG laser capsulotomy rates were higher in the I-FLEX hydrophilic spheric intraocular lens group than in the SA60AT hydrophilic spheric intraocular lens group. Adhesion between capsular bag and intraocular lens by bioadhesive character of hydrophobic acryl intraocular lens may contribute to the prevention of lens epithelial migration and posterior capsule opacification.

Comparison of Nd:YAG Capsulotomy Rates between Hydrophobic and Hydrophilic Intraocular Lenses

PURPOSE: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between hydrophobic and hydrophilic intraocular lenses. METHODS: The present retrospective study enrolled patients who received cataract surgery from a single surgeon between July 2006 to December 2009. Patients included in the study were implanted with SA60AT hydrophobic spherical intraocular lenses (Alcon, Fort Worth, TX, USA, 268 eyes) or I-FLEX hydrophilic spheric intraocular lenses (i-Medical®, Ophthalmic International Heidelberg GmbH, Mannheim, Germany, 331 eyes). The Nd:YAG capsulotomy rates and best-corrected visual acuity (BCVA) were compared between the two groups for 2 years after the operation. RESULTS: The mean follow-up period was 23.5 months and 22.6 months and the mean age was 68.6 years and 70.3 years in the SA60AT and I-FLEX groups, respectively. Follow-up periods were longer in the SA60AT group (p = 0.035), but ages were not significantly different between the two groups (p = 0.367). Nd:YAG laser capsulotomy rates were 6.3% in the SA60AT group and 11.2% in the I-FLEX group. Nd:YAG laser capsulotomy rates were significantly higher in the I-FLEX group (p = 0.020). BCVA before and after the Nd:YAG laser capsulotomy was not significantly different. CONCLUSIONS: Nd:YAG laser capsulotomy rates were higher in the I-FLEX hydrophilic spheric intraocular lens group than in the SA60AT hydrophilic spheric intraocular lens group. Adhesion between capsular bag and intraocular lens by bioadhesive character of hydrophobic acryl intraocular lens may contribute to the prevention of lens epithelial migration and posterior capsule opacification.

Comparison of Six-Month Outcomes in Eyes with Two Hydrophilic Aspheric Intraocular Lenses after Cataract Surgery

PURPOSE: To compare the six-month clinical outcomes of Tek-Lens II model 872 (Tekia, Inc.) and Akreos MI-60 (Bausch & Lomb, Inc.) hydrophilic aspheric intraocular lenses (IOLs) implanted in-the-bag. METHODS: After phacoemulsification was performed by a single surgeon (JY Kim), two different hydrophilic aspheric IOLs were implanted: the Tek-Lens II IOL in 57 eyes and the MI60 IOL in 49 eyes. The best corrected visual acuity (BCVA), refractive error (RE), total high-order aberration (HOA), anterior chamber depth (ACD), and contrast sensitivity (CS) were measured preoperatively and one, three, and six months postoperatively. All parameters were analyzed using the independent t-test to compare the two IOL groups. RESULTS: There was no significant difference in the BCVA, RE, or HOA between the two groups at any of the follow-up visits. Three months postoperatively, the ACD of the TEK-Lens II group as measured by corneal topography was significantly shallower than that of the MI60 group (3.67 +/- 0.52 mm vs. 4.10 +/- 0.40 mm; p = 0.008), and most of the photopic CS in the Tek-Lens II group was significantly higher than that in the MI60 group (all p < 0.05). CONCLUSIONS: The Tek-Lens II IOL showed comparable clinical outcomes with a proven hydrophilic aspheric IOL for the postoperative six months.