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J Cataract Refract Surg ; 32(2): 341-6, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16565014

RESUMO

A 55-year-old man had uneventful phacoemulsification with implantation of a 3-piece silicone intraocular lens (IOL). Postoperative medications included antibiotic-steroid drops and ointments. Eight months postoperatively, the patient started having recurrent episodes of anterior chamber inflammatory reaction. Suspicion that lens instability was causing the reactions led to a lens repositioning procedure 11 months after the initial surgical implantation and again at 13 months. Eighteen months postoperatively, the IOL had a "greasy" film. Despite antiinflammatory and antibiotic treatment, the clinical outcome did not improve. Twenty-seven months after implantation, the lens was exchanged with a hydrophilic acrylic IOL. The course after the exchange was uneventful. The explanted lens was examined by gross and microscopic evaluations, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and gas chromatography-mass spectrometry (GC-MS) using electronic ionization. Gross and microscopic evaluations confirmed the presence of a thin, oily film covering the IOL optic surface. Surface analyses at the level of the oily substance showed unspecific peaks of sodium, chloride, and potassium. The GC-MS analysis showed the presence of compounds characteristic of hydrocarbons, including docosane, tricosane, and tetracosane, which are commonly found in the vehicle of ophthalmic ointments. The GC-MS analysis of 1 ointment used postoperatively found matching peaks, suggesting deposition of those compounds on the IOL.


Assuntos
Lentes Intraoculares , Bases para Pomadas/efeitos adversos , Complicações Pós-Operatórias , Falha de Prótese , Elastômeros de Silicone , Remoção de Dispositivo , Dexametasona/química , Microanálise por Sonda Eletrônica , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Implante de Lente Intraocular , Masculino , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Bases para Pomadas/química , Pomadas/química , Facoemulsificação , Reoperação , Tobramicina/química
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