Single-piece Hydrophobic Acrylic Lens Research Articles

Explantation of a glistening-free, hydrophobic acrylic intraocular lens with cosmetic imperfections on the lens surface

The enVista intraocular lens (IOL), model MX60E is a single-piece hydrophobic acrylic lens that became available in early 2018. Several months later, certain lot numbers were recalled by the manufacturer due to reports of cosmetic imperfections on the IOL surface. We describe a case of an enVista IOL, model MX60E, exhibiting such cosmetic imperfections, which was explanted due to unwanted optical symptoms, from a patient with a medical history of sarcoidosis. Laboratory evaluation of the explanted lens revealed the presence of multiple concentric rings throughout the surface of the optic component, which appeared to correspond to manufacturing marks. The patient's undesired visual symptoms resolved after IOL exchange.

Pathological evaluation of postmortem human eyes implanted with a new single-piece hydrophobic acrylic lens

Purpose: To report the pathological findings in 14 human cadaver eyes implanted with a single-piece AcrySof® (Alcon Laboratories) posterior chamber intraocular lens (IOL). Setting: David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Methods: Fourteen human autopsy eyes implanted with a single-piece AcrySof (SA30AL) IOL were evaluated. The eyes were sectioned at the equatorial plane, and the anterior segment containing the IOL in the capsular bag was evaluated from a posterior perspective (Miyake-Apple view) and from an anterior perspective (surgeon's view) after removal of cornea and iris. They were then processed through paraffin, sectioned, and stained with hematoxylin–eosin, periodic acid-Schiff, and Masson's trichrome and examined under light microscopy. Results: All IOLs had symmetric in-the-bag fixation. Slight decentration was measured in 1 eye, which also had an anterior capsule tear. Grade 1 anterior capsule opacification was present in 9 eyes. No central posterior capsule opacification or posterior capsule folds were observed in any eye. Soemmering's ring formation was observed in 5 eyes. Zonular stretch caused by different degrees of capsular bag contraction was present in 4 eyes without decentration of the IOL. Conclusions: Analyses of pseudophakic cadaver eyes from the posterior (Miyake-Apple) view, complemented by microscopic analyses, proved useful in the evaluation of IOL–capsular bag interaction. These studies are more important in cases of newly introduced lens designs.