Intraocular lens calcification; a clinicopathologic report

To describe the clinical and pathological features of a case of hydrogel intraocular lens [IOL] calcification. A 48-year-old man underwent explantation of a single-piece hydrophilic acrylic intraocular lens in his left eye because of decreased visual acuity and milky white opalescence of the IOL. The opacified lens was exchanged uneventfully with a hydrophobic acrylic IOL. Gross examination of the explanted IOL disclosed opacification of the optic and haptics. Full-thickness sections of the lens optic were stained with hematoxylin and eosin [H and E], von Kossa and Gram Tworts'. Microscopic examination of the sections revealed fine and diffuse basophilic granular deposits of variable size within the lens optic parallel to the lens curvature but separated from the surface by a moderately clear zone. The deposits were of high calcium content as evident by dark brown staining with von Kossa. Gram Tworts' staining disclosed no microorganisms. This report further contributes to the existing literature on hydrogel IOL calcification

Steroid induced ocular hypertension following myopic photorefractive keratectomy

To determine the incidence of steroid induced ocular hypertension following myopic photorefractive keratectomy [PRK]. Myopic PRK was performed on 506 eyes of 269 patients. Preoperatively, spherical equivalent refractive error ranged from -1.00 to -5.00 diopters [D] and cylinder was less than 4 D. Baseline intraocular pressure [IOP] before PRK and at different time intervals after the procedure was measured by Goldmann applanation tonometry. IOP readings were corrected according to central corneal thickness as measured by Orbscan pachymetry. For the purpose of the study, corrected IOP >21 mmHg was considered as ocular hypertension. Ocular hypertension developed in 40 [7.9%] eyes overall, which occurred in 16 eyes [40%] 2-3 weeks postoperatively [mean IOP = 23.5 +/- 3.0mmHg], in 20 eyes [50%] after 4-6 weeks [mean IOP = 25.1 +/- 4.2 mmHg] and in 4 eyes [10%] 8-12 weeks following PRK [mean IOP = 29.0 +/- 3.1 mmHg]. There was no correlation between the level of IOP rise and preoperative spherical equivalent refractive error. IOP recovered to normal in all eyes after discontinuation of topical steroids and initiation of anti-glaucoma medications. Mean duration of IOP normalization was 28.5 +/- 27.7 [range 7-108] days and no instance of steroid-induced glaucoma was observed in any patient. Topical steroids may cause ocular hypertension following PRK. Early detec-tion, prompt treatment and close follow-up are recommended. We suggest measuring IOP in post-PRK patients no later than 10 to 14 days after initiation of corticosteroid treatment