Intraoperative Opacification of a Hydrophilic Acrylic With Hydrophobic Surface IOL With Spontaneous Resolution in 24 Hours

Abstract

To report an intraocular lens opacification case during cataract surgery. An 80-year-old woman with a history of hypertension and type 2 diabetes mellitus presented with advanced nuclear cataract in her left eye and underwent coaxial phacoemulsification through a 1.8-mm micro-incision and insertion of an in-the-bag intraocular lens (IOL). There was subsequently rapid, homogenous, and complete opacification of the lens, which remained opaque for 2 hours postoperatively. At 24 hours postoperatively, the IOL was transparent with no signs of opacification and the only findings were moderate corneal edema and mild remains of sub-incisional cortex. At the last postoperative visit 1 month after surgery, the IOL remained clear and the visual acuity was 20/20. The same conditions were reproduced in vitro and the same complete and homogenous opacification of the lens was observed. After an extensive review of the literature about other IOL opacification cases reported, no previously published case related to this condensation was found. The description of the temporary IOL opacification phenomenon due to condensation could be useful to cataract surgeons, who might avoid cold storage of IOLs. The known self-resolution of this type of IOL opacification makes advisable to delay IOL surgical explantation in these cases.