Surface abnormalities on hydrophilic acrylic intraocular lenses implanted by an injector.

PURPOSE: To describe and evaluate abnormalities on the surface of hydrophilic acrylic intraocular lenses (IOLs) that were implanted using an injector. SETTING: Department of Ophthalmology, University of Graz, Graz, Austria. METHODS: This study comprised 70 eyes having phacoemulsification and implantation of an EasAcryl (n = 50) or Inject-A (n = 20) IOL. Both hydrophilic IOLs are biconvex and have a high water content (26%), plate-haptic design, and no angulation. The IOLs were folded in a cartridge under hydroxypropyl methylcellulose and implanted by an injector. RESULTS: Thirteen EasAcryl and 5 Inject-A IOLs had multiple white lines in the direction of the longitudinal axis on the posterior surface immediately after implantation. On 1 EasAcryl IOL, the white lines were separated by a clear central zone and were on the anterior surface. Another EasAcryl IOL had a 1.0 mm crack. CONCLUSIONS: The abnormalities on the posterior surface of high-water-content hydrophilic acrylic IOLs disappeared or were almost gone within 1 month postoperatively and do not appear to be a concern for surgeons. These abnormalities are likely the result of the IOLs' hydrophilicity and high water content and friction in the injector barrel.

Phototherapeutic keratectomy of a corneal scar due to presumed infection after photorefractive keratectomy.

This case involves a 25-year-old patient who suffered from corneal ulceration several days after photorefractive keratectomy (PRK). A central scar developed, resulting in discomfort and reduction in visual acuity. Four months later, the scar was treated by phototherapeutic keratectomy (PTK) (25 microns depth, 5 mm ablation zone). Some scar tissue was left, but it cleared slowly and steadily over the next few years. The induced hyperopia decreased from 5.00 to 1.37 diopters spherical equivalent within 28 months postoperatively. Best corrected visual acuity increased from 20/60 preoperatively to 20/20 at 28 months postoperatively. Surgeons can encourage patients with postinfectious scars after PRK to try at least 1 PTK treatment.

Complete capsulorhexis opening occlusion despite capsular tension ring implantation.

An 89-year-old woman and an 86-year-old woman had continuous curvilinear capsulorhexis, phacoemulsification, and implantation of a silicone plate-haptic intraocular lens. Because of presumed weak zonules (high age, pseudoexfoliation), a poly(methyl methacrylate) capsular tension ring was also implanted. Despite this, both patients reported deterioration in visual acuity that was the result of complete occlusion of the anterior capsule opening by fibrotic tissue 4 and 3 months postoperatively, respectively.