Patient: 58 years of age, female, BCVA 0.3.
Ocular Medical History: myopia, regular cataract surgery in 08/2009 with implantation of Acrysof, IQ IOL, SN60WF, 15 dpt, 13 mm with good postoperative visual acuity. Four years after surgery decrease of visual acuity.
General Medical History: empty
Main Complaint: decreased vision at OD.
Purpose: to demonstrate a secondary opacification of an hydrophob acrylic IOL with multiple, fine, granular, brown deposits.
Methods: Colour Photography, SD-OCT (Spectralis, HE, Heidelberg Engineering), w-w-perimetry.
Findings:
Colour Photography: no capsular fibrosis, opacification of the posterior curvature of IOL with multiple, fine, granular, brown deposits of various sizes on the posterior surface of the lens optics at OD .
SD-OCT: regular macula at OD.
w-w-Perimetry: regular visual field at OD.
Discussion:
Miyake et al. (1) reported, that greater postoperative inflammation and more rapid anterior capsule opacification was seen in the eyes with hydrophobic IOLs. The AcrySof® IQ is an acrylic foldable single-piece posterior chamber intraocular lens . While the complication of delayed opacification of posterior surface is rare and the exact pathophysiology poorly understood, it must be considered in a pseudophakic patient with an unexplained decrease in visual acuity.
Literature:
(1) Miyake, I. Ota, S. Miyake, K. Maekubo. Correlation between intraocular lens hydrophilicity and anterior capsule opacification and aqueous flare. K. J Cataract Refract Surg, 22 (1996), pp. 764–769
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