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Unusual markings on an intraocular lens postoperatively.

Mehta A - Indian J Ophthalmol (2012 May-Jun)

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Dear Editor, The clear refractive surface of intraocular lenses (IOLs) may be clouded by inflammatory deposits, cells (posterior capsular opacification) or denaturation of the lens material itself... Our patient had highly unusual deposits on the lens postoperatively... Ltd.) was implanted through its circular plastic cartridge... On the first postoperative day, the patient had significant anterior chamber reaction, with Grade 4+ cells and trace hypopyon... Unlike typical inflammatory deposits which tend to be scattered and diffuse, they had a precise linear arrangement... Postoperative causes of opacification include inflammatory/fibrin deposits and posterior capsular opacification... Such explanted lenses have been studied using methods like staining, transmission electron microscopy and elemental analysis... In almost all cases, the deposits were found to be calcium salts... The deposits in our patient did not fit clearly into any of the described categories... The deposits may have been inflammatory in nature or a very low-grade toxic anterior segment syndrome... However, inflammatory deposits are rarely ever found in such precise parallel lines and they usually either disappear in a few days after anti-inflammatory medication or form permanent membranes... It is possible that some viscoelastic/ ethylene oxide (ETO) residue remained on parts of the lens surface and these areas then became a nidus for a mild secondary calcification... In this case their disappearance is most unusual.

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Unusual parallel markings on the posterior surface of the intraocular lens seen postoperatively
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Figure 1: Unusual parallel markings on the posterior surface of the intraocular lens seen postoperatively

Mentions: On the first postoperative day, the patient had significant anterior chamber reaction, with Grade 4+ cells and trace hypopyon. The cornea was clear. Her vision was 20/40. The fundus appeared normal. The reaction subsided with medication, over a period of two to three days, with cells decreasing to 2+ with no hypopyon. At this stage, seven to nine thin, elongated, oval-shaped markings were clearly noticeable on the posterior surface of the lens optic. These were between 3-7 mm long, about 1-3 mm wide, and arranged parallel to one another [Fig. 1] in a horizontally slanting direction across the back surface of the optic. These lines were perpendicular to the direction of the lens folding in the cartridge, not along it. These were not typical scratch marks or folding lines. They appeared to be deposits. Unlike typical inflammatory deposits which tend to be scattered and diffuse, they had a precise linear arrangement.


Unusual markings on an intraocular lens postoperatively.

Mehta A - Indian J Ophthalmol (2012 May-Jun)

Unusual parallel markings on the posterior surface of the intraocular lens seen postoperatively
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3361829&req=5

Figure 1: Unusual parallel markings on the posterior surface of the intraocular lens seen postoperatively
Mentions: On the first postoperative day, the patient had significant anterior chamber reaction, with Grade 4+ cells and trace hypopyon. The cornea was clear. Her vision was 20/40. The fundus appeared normal. The reaction subsided with medication, over a period of two to three days, with cells decreasing to 2+ with no hypopyon. At this stage, seven to nine thin, elongated, oval-shaped markings were clearly noticeable on the posterior surface of the lens optic. These were between 3-7 mm long, about 1-3 mm wide, and arranged parallel to one another [Fig. 1] in a horizontally slanting direction across the back surface of the optic. These lines were perpendicular to the direction of the lens folding in the cartridge, not along it. These were not typical scratch marks or folding lines. They appeared to be deposits. Unlike typical inflammatory deposits which tend to be scattered and diffuse, they had a precise linear arrangement.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor, The clear refractive surface of intraocular lenses (IOLs) may be clouded by inflammatory deposits, cells (posterior capsular opacification) or denaturation of the lens material itself... Our patient had highly unusual deposits on the lens postoperatively... Ltd.) was implanted through its circular plastic cartridge... On the first postoperative day, the patient had significant anterior chamber reaction, with Grade 4+ cells and trace hypopyon... Unlike typical inflammatory deposits which tend to be scattered and diffuse, they had a precise linear arrangement... Postoperative causes of opacification include inflammatory/fibrin deposits and posterior capsular opacification... Such explanted lenses have been studied using methods like staining, transmission electron microscopy and elemental analysis... In almost all cases, the deposits were found to be calcium salts... The deposits in our patient did not fit clearly into any of the described categories... The deposits may have been inflammatory in nature or a very low-grade toxic anterior segment syndrome... However, inflammatory deposits are rarely ever found in such precise parallel lines and they usually either disappear in a few days after anti-inflammatory medication or form permanent membranes... It is possible that some viscoelastic/ ethylene oxide (ETO) residue remained on parts of the lens surface and these areas then became a nidus for a mild secondary calcification... In this case their disappearance is most unusual.

Show MeSH