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| Clinical and Experimental Study of Intraocular Lens Opacity after Pars Plana Vitrectomy |
| Shilan Mao, Jin Xie, Ting Liu, Lei Wan, Nan Chen, Yunhai Dai |
| Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China |
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Abstract Objective: To investigate the case characteristics and risk factors for intraocular lens(IOL) opacities after pars plana vitrectomy (PPV). Methods: In this retrospective study, two of the retrieved and well preserved IOLs were chosen for experimental studies including in vitro light microscopy, scanning electron microscopy, laser confocal microscopy, and energy dispersive spectrometer analysis to evaluate the case data of 11 patients who developed IOL opacities after PPV surgery at Qingdao Eye Hospital of Shandong First Medical University from February 2007 to February 2022. Results: The age of the 11 patients ranged from 63.3±15.0 (23 to 76) years, and the duration between IOL opacity and PPV was assessed to be 82.2±45.7 (24 to 180) months. Eight patients underwent retinal photocoagulation, five had intraocular silicone oil/gas injection surgery, and one had glaucoma surgery. Six cases of diabetes and five cases of hypertension were identified as systemic diseases. The patients' IOLs and clinical disposition were as follows: hydrophilic acrylates in 9 instances (9/11), including type 860UV (1 case, removed), Akreos Adapt AO (2 cases, 1 removed), and hydrophilic acrylic material with a hydrophobic surface coating L-312 (6 cases, 4 removed); and hydrophobic acrylate MA60MA in the other two cases (2/11, not removed). The study revealed two opacities IOLs: the first was an 860UV type IOL with the opacities component primarily positioned on the optical section's front surface. It was diffuse, uneven, earthworm-shaped, and ridge-shaped under the light microscope and scanning electron microscopy, with no obvious sediment at the loop and around; laser confocal microscopy revealed that the opacities were primarily concentrated in the anterior superficial layer, with a depth of approximately anterior 6.9% of the overall thickness of the IOL. Energy dispersive spectrometer examination showed that carbon, oxygen, calcium, phosphorus, silicon, and magnesium were arranged according to the amount of content; The second was an Akreos Adapt AO type IOL, which had opacities principally in the optical zone, under light microscopy and scanning electron microscopy, coarse, microscopic spherical sand grains, as well as sand grains in the loop and peripheral areas. Laser confocal microscopy showed that the opacities were deeper, at about Anterior 12.5% of the total thickness of the IOL. Energy dispersive spectrometer examination showed that carbon, oxygen, and silicon were arranged according to the amount of content. Conclusion: Opacities can occur with different types of acrylate IOLs following PPV, and the shape and surface deposits of IOL opacities vary.
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Received: 30 June 2022
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| Fund:National Natural Science Foundation of China (81600721) |
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Corresponding Authors:
Yunhai Dai, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China (yunhaidai@163.com)
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