Imaging After Cataract and Intraocular Lens Implant Surgery

Abstract

The intraocular (crystalline) lens is a biconvex structure that serves to refract the incident light in conjunction with the cornea. The crystalline lens is comprised of the lens capsule (which completely surrounds the lens anteriorly and posteriorly), the lens epithelium, and lens fibers (which includes the cortex). Cataracts consist of opacification of the normally transparent intraocular lens and collectively represent the most common cause of vision loss. There are several etiologies for the development of cataracts, which can be congenital or more commonly acquired as a result of age-related degeneration, trauma, intraocular inflammation, exposure to ionizing radiation, and through the use of certain systemic or topical medications, such as corticosteroids. Cataract surgery is generally performed when the decrease in visual acuity or the presence of progressive glare limits a patient’s activities of daily life. Surgical options for treating cataracts include lensectomy with aphakia and lensectomy with artificial intraocular lens implantation (pseudophakia). Intraocular lens implants are also used in the treatment of myopia (phakic intraocular lens implantation) and hyperopia (piggyback intraocular lenses). Imaging after cataract surgery and phakic intraocular lens implantation is indicated for the evaluation of potential complications in cases of intraocular hemorrhage or corneal edema that obscures the clinical view to the fundus. The modalities of choice include B-mode ultrasound, UBM, and OCT. Otherwise, sequelae of cataract surgery and phakic intraocular lens implantation can be encountered as incidental findings on CT and MRI that include the orbits. The corresponding imaging findings of cataract surgery on the various modalities and associated complications are reviewed in the subsequent sections.