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| PHOTO ESSAY |
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| Year : 2023 | Volume
: 3
| Issue : 2 | Page : 558-559 |
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Intraocular lens opacification - “The Hidden Pearl”
Mamta Agarwal1, Gazal Patnaik2, Janaki Narayanan3
1 Uveitis and Cornea Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
2 Department of Uvea and Cataract Services, Sankara Nethralaya, Kolkata, West Bengal, India
3 Department of Nanobiotechnology, Vision Research Foundation, Chennai, Tamil Nadu, India
| Date of Submission | 05-Feb-2023 |
| Date of Acceptance | 20-Feb-2023 |
| Date of Web Publication | 28-Apr-2023 |
Correspondence Address:
Mamta Agarwal
Uveitis and Cornea Services, Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai - 600 006 Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJO.IJO_357_23
Keywords: Intraocular lens opacification, intraocular lens, mature cataract, scanning electron microscopy
How to cite this article:
Agarwal M, Patnaik G, Narayanan J. Intraocular lens opacification - “The Hidden Pearl”. Indian J Ophthalmol Case Rep 2023;3:558-9 |
A 64-year-old woman presented with decreased vision in the left eye (best-corrected visual acuity [BCVA]–20/40) for the last 6 months, with a history of cataract surgery 4 years ago. Slit-lamp examination showed a white pupillary reflex simulating a mature cataract [Figure 1]a and an opacified “pearly white” intraocular lens (IOL-Acriva-BBUD613) [Figure 1]b and [Figure 1]c, which was then exchanged with acrylic hydrophobic IOL, improving vision to 20/20. Scanning electron microscopy of IOL showed numerous fine, granular crystalline deposits and inflammatory cellular deposits on both optic and haptics (350×) [Figure 1]d, [Figure 1]e, [Figure 1]f, possibly due to the supersaturation of aqueous humor with calcium phosphates.[1],[2] | Figure 1: Slit-lamp image shows (a) white pupillary reflex, (b and c) an opacified “pearly white” intraocular lens (Acriva-BBUD613), and explanted IOL (inset). Scanning electron microscopy (d-f) shows numerous crystalline and cellular deposits on the optic and haptics of IOL (SEM× 350)
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| Discussion | |  |
Late postoperative IOL opacification is a rare complication, mechanism of which is still unclear and related to the supersaturation of aqueous humor with calcium phosphates.[1] The nature of IOL material, inadequate cortex cleaning from the capsular bag and blood aqueous barrier breakdown have been reported to be the possible factors for IOL opacification.[1],[2]
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 initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Acknowledgment for funding the equipment
Department of Biotechnology, Govt. of India (sanction no. BT/PR26926/NNT/28/1500/2017).
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Fernández J, Sánchez-García A, Rodríguez-Vallejo M, Piñero DP. Systematic review of potential causes of intraocular lens opacification. Clin Exp Ophthalmol 2020;48:89-97.  |
| 2. | Gartaganis SP, Kanellopoulou DG, Mela EK, Panteli VS, Koutsoukos PG. Opacification of hydrophilic acrylic intraocular lens attributable to calcification: Investigation on mechanism. Am J Ophthalmol 2008;146:395-403. |
[Figure 1]
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