Intraoperative crytallization on the intraocular len urface Original Reearch Article

PURPOE: To report a phyician urvey, laboratory tudie, and clinical obervation of intraoperative crytallization on the urface of the intraocular len (IOL). METHOD: We ent a urvey to all ophthalmologit in the tate of Wyoming, Idaho, Montana, Utah, and Colorado aking whether crytallization on the IOL urface had occurred in any of their patient and what vicoelatic, IOL, and other olution were ued. All returned urvey were tabulated and analyzed by tandard tatitical mean. A ample of crytallization from an IOL on a gla lide ubmitted by a phyician wa analyzed to acertain the relative elemental compoition. During in vitro laboratory tudie, B Plu (Alcon urgical, Fort Worth, Texa) and B (Alcon urgical) were meaured and analyzed for precipitation. Healon GV (Pharmacia/Upjohn, Kalamazoo, Michigan) and calcium chloride were combined in variou olution and examined for precipitate formation. ilicone IOL and plate ilicone were placed in different B and B Plu olution with different vicoelatic and varying calcium concentration. In even patient, prominent crytallization on an IOL urface wa examined, photographed, and followed for up to 3 year. REULT: Two hundred ix urveyed ophthalmologit returned 181 urvey (88%) and reported 29,609 cataract urgerie, with IOL implantation with 22 eye (0.07%) (22 patient) in which intraoperative crytallization wa oberved on the IOL urface during 1993. The urvey indicated there wa a correlation with B Plu (chi-quare = 4.9, P = .0268) and ilicone IOL (chi-quare = 6.8, P = .0093). The ample howed the cation to be calcium. CONCLUION: Crytallization on the IOL urface during cataract urgery i a rare occurrence that may be aociated with calcium a the cation related to an omotic gradient around the IOL with increaed calcium concentration. If encountered urgically, the len hould be exchanged in the operating theater after irrigating the anterior chamber with B and completely filling the capular bag with a low molecular weight vicoelatic