Propoed pathogenei for the delayed potoperative opacification of the hydroview hydrogel intraocular len

Purpoe To report the clinical, hitopathologic, ultratructural, and elemental feature of 17 opacified Hydroview (Bauch and Lomb urgical, Rocheter, New York, UA) hydrogel intraocular lene (IOL) neceitating explantation and dicu from a clinicopathologic perpective why thee lene became opacified. Deign Interventional cae erie with clinicopathologic correlation. Method eventeen hydrogel lene were explanted from 17 different patient owing to decreaed viual acuity or quality of viion an average of 29 month after uneventful phacoemulification and IOL implantation and aociated with a granular-appearing opacification uperficially within the optic. Lene were examined by light microcopy, tranmiion electron microcopy (TEM), and energy diperion x-ray (EDX) pectrocopy. A control IOL wa included in our tudy. Reult All explanted lene howed poitive taining for calcium by light microcopy. Tranmiion electron microcopy dicloed electron-dene crytalline depoit in the uperficial ubtance of the IOL optic. Energy diperion x-ray pectra analye howed the preence of calcium and phophoru mainly in the electron-dene periphery of the depoit in all of the pecimen and the preence of ilicon mainly in the electron-lucent center of the depoit in the majority of the pecimen. No poitive taining or depoit were oberved on the IOL control or in the haptic. Concluion Our tudy i the firt to demontrate that the calcium depoit are aociated with ilicon, which wa preumably derived from the ilicone gaket in the urefold (Bauch and Lomb urgical, Rocheter, New York, UA) packaging ytem, manufactured pecifically for thi IOL. ilicon may act a a nidu for calcium depoition within the len, which i conitent with our finding. There may be other factor involved, and thi important clinical problem require further tudy.