Investigation of visual and contrast sensitivity disturbance caused by opacification of hydrogel intraocular lenses (H60M)

Abstract

Abstract: : Purpose: To investigate the clinical, histopathologic, ultrastructural results of delayed onset opacification of hydrogel intraocular lenses(H60M). Methods: The study includes seven eyes which underwent uncomplicated phacoemulsification and H60M implantation with good visual recovery, presenting at 20–40 months after surgery with visual and contrast sensitivity disturbance resulting from opacification of the IOL. All patients underwent IOL exchange surgery. Contrast sensitivity of patients were examined before and after IOL exchange surgery, and IOLs were examined by light microscopy and transmission electron microscopy (TEM). Results: Because of opacification of H60M, contrast sensitivity disturbance of patients, which was more remarkable than visual disturbance, decreased before IOL exchange surgery and recovered after IOL exchange surgery. Light microscopy and transmission electron microscopy revealed diffuse granular deposits covering the optic surface of IOLs. Light microscopic staining techniques and transmission electron microscopy confirmed the deposites to be silicon and calcium phosphate salts. Conclusions: All explanted IOLs were derived from silicon gasket in the Surefold packaging system. It is considered that contrast sensitivity test may be best examination when we decide the time of IOL exchange surgery, and careful clinical follow up of patients implanted with H60M is necessary.

Keywords: calcium • contrast sensitivity • visual acuity