Serial intraocular lens opacifications of different designs from the same manufacturer: Clinical and light microscopic results of 71 explant cases

Purpose: To report clinical findings and light microscopic results of 71 opacified hydrophilic acrylic intraocular lenses (IOLs). Setting: Vivantes Klinikum Neukoelln, Ophthalmology Department, Berlin, Germany. Design: Retrospective case series. Methods: Sixty-three patients (71 eyes) were referred to the clinic because of vision-impairing IOL opacification between December 2012 and September 2016 after routine cataract surgery elsewhere. The explanted IOLs were analyzed with light microscopy at the John A. Moran Eye Center (University of Utah, Salt Lake City, Utah, USA). Medical records were reviewed for visual acuity, comorbidities, and complications. Clinical follow up was 6 months. Results: Seventy-one opacified 1-piece or 3-piece hydrophilic acrylic IOLs (Lentis) of different designs from 2009 to 2012 (LS-502-1, LS-402-1Y, LS 312-1Y, LS-313-1Y, L-402, L-312) were found. Morphological findings were surface, subsurface, or deep calcifications of the IOL material. Explantation was performed 4 years +/- 1.2 (SD) after initial phacoemulsification. The mean patient age was 78.6 +/- 8.2 years. Ocular and systemic comorbidities were found without statistical correlation: the most frequent were diabetes, uveitis, and glaucoma. The preoperative mean corrected distance visual acuity changed from 0.63 +/- 0.47 logarithm of the minimum angle of resolution (logMAR) to 0.20 +/- 0.28 logMAR postoperatively (P < .001). Conclusions: Different designs of IOLs by the same manufacturer, implanted between 2009 and 2012, developed late calcification with significant visual loss after routine cataract surgery. No medical, surgical, or ophthalmologic trigger could be determined. A manufacture issue might be the reason for the opacification. (C) 2018 ASCRS and ESCRS