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Introduction
Currently, intraocular lens (IOL) opacification is a rare but a well-known late-term complication of cataract surgery.1–12 Although several studies have shown late opacifications of polymethylmethacrylate,1,2 silicone,3,4 hydrophilic acrylic,5–19 and hydrophilic acrylic coated with hydrophobic surface IOL designs,20,21 visually significant opacification leading to IOL explantation is commonly reported in cases with hydrophilic acrylic IOLs.12–20
Recently published case reports have demonstrated opacified hydrophilic acrylic IOLs after ocular surgeries such as corneal transplantation procedures involving multiple injections of intracameral gas or vitreoretinal interventions combined with intravitreal SF6 or C3F8 gas injections.6–10,14–16 Gross and histochemical analysis of explanted hydrophilic acrylic IOLs revealed that calcium phosphate crystalline deposits on or within the optic material are the main reason of opacification.20–23 Because various factors may be the cause of such calcification, which has been attributed to IOL material itself, presence of phosphate components in the ophthalmic viscosurgical devices (OVDs) or calcium in the irrigating solutions used during phacoemulsification surgery, as well as the supersaturated content of aqueous humor, the exact mechanism is still unknown.22–25 However, opacification following silicone oil (SO) injection is a less well-known phenomenon.18,19 Herein, we report a case series of 32 eyes with IOL opacification following vitrectomy and SO injection.
Patients and Methods
Thirty-two eyes of 31 patients with the diagnosis of IOL opacification between September 2010 and May 2019 were evaluated retrospectively. All patients had been referred to Dokuz Eylul University, Department of Ophthalmology, with the diagnosis of rhegmatogenous retinal detachment and had a history of previous phacoemulsification with hydrophilic acrylic IOL implantation. In all eyes, due to the presence of large, multiple and/or inferior tears with or without proliferative vitreoretinopathy (PVR) immediate 23- or 25-gauge pars plana vitrectomy (PPV) was performed using 1,300 centistoke (cs) SO endotamponade (Oxane; Bausch + Lomb, Rochester, NY). Silicone oil removal (SOR) was performed with two-port 23- or 25-gauge vitrectomy, where SO was exchanged with balanced salt solution (BSS; Alcon Laboratories, Fort Worth, TX).
Demographics as well as the data about the ophthalmologic examinations, including best-corrected visual acuity (BCVA), intraocular pressure, slit-lamp and retina evaluation including B-scan ultrasonography scans of all study participants, were recorded. Details about their previous cataract surgeries were collected from their previous...