Atlas of Ophthalmology

Delayed Opacification of Posterior Surface of Hydrophob Acrylic IOL (Colour Photography, OCT, VF)

Lens -> Post-surgical Cases
Patient: 58 years of age, female, BCVA 0.3. Ocular Medical History: myopia, regular cataract surgery in 08/2009 with implantation of Acrysof, IQ IOL, SN60WF, 15 dpt, 13 mm with good postoperative visual acuity. Four years after surgery decrease of visual acuity. General Medical History: empty Main Complaint: decreased vision at OD. Purpose: to demonstrate a secondary opacification of an hydrophob acrylic IOL with multiple, fine, granular, brown deposits. Methods: Colour Photography, SD-OCT (Spectralis, HE, Heidelberg Engineering), w-w-perimetry. Findings: Colour Photography: no capsular fibrosis, opacification of the posterior curvature of IOL with multiple, fine, granular, brown deposits of various sizes on the posterior surface of the lens optics at OD . SD-OCT: regular macula at OD. w-w-Perimetry: regular visual field at OD. Discussion: Miyake et al. (1) reported, that greater postoperative inflammation and more rapid anterior capsule opacification was seen in the eyes with hydrophobic IOLs. The AcrySof® IQ is an acrylic foldable single-piece posterior chamber intraocular lens . While the complication of delayed opacification of posterior surface is rare and the exact pathophysiology poorly understood, it must be considered in a pseudophakic patient with an unexplained decrease in visual acuity. Literature: (1) Miyake, I. Ota, S. Miyake, K. Maekubo. Correlation between intraocular lens hydrophilicity and anterior capsule opacification and aqueous flare. K. J Cataract Refract Surg, 22 (1996), pp. 764–769

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