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 Table of Contents  
OPHTHALMIC IMAGE
Year : 2021  |  Volume : 1  |  Issue : 4  |  Page : 868

Opacified intraocular lens: A clinching diagnosis


Department of Cataract Services, Aravind Eye Hospital, Coimbatore, Tamilnadu, India

Date of Web Publication09-Oct-2021

Correspondence Address:
Dr. D Bala Sarasawathy
Aravind Eye Hospital, Civil Aerodrome Post, Sitra, Coimbatore - 641 014, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_418_21

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How to cite this article:
Sarasawathy D B, Narendran KS. Opacified intraocular lens: A clinching diagnosis. Indian J Ophthalmol Case Rep 2021;1:868

How to cite this URL:
Sarasawathy D B, Narendran KS. Opacified intraocular lens: A clinching diagnosis. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Oct 26];1:868. Available from: https://www.ijoreports.in/text.asp?2021/1/4/868/327689



A 65-year-old male patient presented with hand movements in right eye for past 6 months. On examination, undilated right eye (RE) looked like a hypermature absorbed cataract [Figure 1]. He gave a history of lens exchange procedure in RE 3 years back. In B scan, we found intraocular lens (IOL) reverberation and in IOL master 700, lens thickness was less and anterior chamber depth was deep, indicating opacified IOL in anterior segment optical coherence tomography (AS OCT) [Figure 2]. IOL formula used here is SRK-T formula in pseudophakic mode, which is quite accurate in calculations with axial length and keratometer reading in such situations. IOL exchange was done and in-the-bag IOL was placed and vision improved to 6/9p [Figure 3]. Opacified IOL is a rare late postoperative complication after an uneventful phacoemulsification surgery occurring in a hydrophilic lens.[1],[2] This often mimics a mature cataract or posterior capsular opacification.[3] This emphasizes careful slit-lamp examination with other routine investigation like B scan and A scan to clinch the diagnosis and prevent intraoperative surprises. The most challenging complication during IOL exchange is the adhesion of IOL to the capsule and while removing, zonular dehiscence and posterior capsule rupture occur which compromises the placement of secondary IOL in the bag.[4]
Figure 1: Opacified IOL mimicking as mature cataract. On closer examination can see rhexis margin on the left side

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Figure 2: (a) B scan showing IOL reverberation (white arrow) seen in pseudophakic cases. (b) A scan by IOL master 700 showing increased anterior chamber depth (ACD), decreased lens thickness (LT) and AS OCT showing posterior chamber IOL (black arrow)

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Figure 3: (a) Explanted IOL with opacification including both optic and haptic. (b) postoperative IOL in the bag after explantation of opacified IOL

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflict of interest.



 
  References Top

1.
Izak AM, Werner L, Pandey SK, Apple DJ. Calcification of modern foldable hydrogel intraocular lens design. Eye (Lond) 2003;17:393-406.  Back to cited text no. 1
    
2.
Tandogan T, Khoramnia R, Choi CY, Scheuerle A, Wenzel M, Hugger P, et al. Optical and material analysis of opacified hydrophilic intraocular lens after explantation: A laboratory study. BMC Ophthalmol 2015;15:170.  Back to cited text no. 2
    
3.
Gupta G, Goyal P, Bal A, Jain AK, Malhotra C. Pearly white intraocular lens opacification- “Tertiary cataract”. Indian J Ophthalmol Case Rep2020;68:188-9.  Back to cited text no. 3
    
4.
Dagres E, Khan MA, Kyle GM, Clark D. Perioperative complications of intraocular lens exchange in patients with opacified Aqua-sense lenses. J Cataract Refract Surg 2004;30:2569-73.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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