Opacification of hydrophilic acryl intraocular lens and their aqueous humor

Abstract

Abstract: : Purpose:To report six cases developed loss of vision resulting from opacification of hydrophilic acryl intraocular lens (IOL) . ( BAUSCH &LOMB ) and to analyze element of aqueous humor and for examination of calcification of hydrophilic acryl IOLs. Methods:38 cases 52 eyes underwent phacoemulsification and implantation of hydrophlic acryl IOLs .The age who necessitating exchanged IOLs was 62.6 years old on the average. Aqueous humor were taken from patients who was necessitating exchanged IOLs after previous vitrectomy and/or cataract surgery. That material was compared to aqueous humor that was taken from five cataract patients with proliferative diabetic retinopathy, and aqueous humor of five cataract patients without diabetes. Elemental analysis of explanted IOLs was performed by energy–dispersive spectrum meter (EDSM) JED–2200. Results:Preoperative complications included diabetes 38 cases (100.0%), simple diabetic retinopathy 7 cases ( 18.4%), proliferative diabetic retinopathy 31 cases (81.6%), hemodialysis due to renal failure 10 cases( 26.3%) and previous vitrectomy for diabetic retinopathy and cataract surgery 10 cases (26.3%). Average duration until explantation IOLs was 18.8months post vitrectomy for diabetic retinopathy and/or cataract surgery. Notably, five of six cases requiring IOLs exchanged had undergone vitrectomy and cataract surgery for diabetic retinopathy and hemodialysis. Calcium and phosphorous were detected on the explanted IOLs by EDSM JED–2200. Concentration of calcium and phosphorous were 3.6 ±2.4mg/dl and 6.5±4.7 mg/dl in aqueous humor necessitating exchanged IOLs .On the other hand , concentration of calcium and phosphorous were 5.9±0.7 mg/dl and 3.4±0.8 mg/dl in aqueous humor with proliferative diabetic retinopathy, concentration of calcium and phosphorous were 5.5±0.8mg/dl and 2.4±0.8 mg/dl in aqueous humor without diabetes. There was no significantly difference between three groups. Conclusions:We do not recommend the implantation of hydrophric acryl IOLs in patients with diabetic retinopathy who have undergone vitrectomy and hemodialysis. Calcification of hydrophilic acryl intraocular lens is not only occurred change of concentration of calcium and phosphorous . The reason for calcification requires further in vitro experimental study.

Keywords: cataract • aqueous • calcium