Transcript JOURNAL CONFERENCE

Opacification of the optic of
an Akeos Adapt® intraocular lens
Chong Eun Lee, MD, Sung Dong Chang, MD, PhD
Department of Ophthalmology, School of Medicine,
Dongsan Medical Center,
Keimyung University, Daegu, Korea
The authors have no financial interest
INTRODUCTION
 The opacifications of intraocular lens, causing
the removal or exchange of implanted
intraocular lens, have been reported to occur in
some hydrophilic acrylic intraocular lens (IOL)
 We experienced a case of the opacification of
hydrophillic intraocular lens (Akreos Adapt ®,
Bausch & Lomb)
 To our knowledge, there was no prior report of
an opacification in that IOL
CASE REPORT
 55-year-old man
 28-year-history of diabetes mellitus (DM)
 Also receiving peritoneal dialysis for chronic
renal failure
 Two months before, at other eye hostpital
 pars plana vitrectomy, panretinal photocoagulation
(for proliferative diabetic retinopathy)
 phacoemulsification & implantation of hydrophillic
acryl intraocular lens in the capsular bag
(Akreos Adapt ®, Bausch & Lomb)
CASE REPORT
 At the time of the first visit, the patient presented
with proliferative diabetic retinopathy in both
eyes and clinically significant macular edema
 Initial best corrected visual acuity (OD) : 0.08
 Four months later
 BCVA (OD) finger count 10 cm
 Intraocular pressure (OD) 38 mmHg
 Rubeosis c hyphema in the right eye
 Dx. : neovascular glaucoma (OD)
CASE REPORT
 Ahmed valve implantation(OD) through pars
plana, at our hospital
 5 months following the surgery of glaucoma
(10 months following the implantation of IOL)
 BCVA (OD) 0.08
 Microhyphema still present
 IOL opacification found
CASE REPORT
 45 months following the implantation of IOL
 BCVA (OD) hand motion
 disappearance of hyphma
 IOL opacification causing a decreased VA was found
(Figure 1)
 IOL was explanted from the right eye &
Hydrophobic acrylic IOL, YA-60BB (HOYA®,
Japan), was implanted into the sulcus
Figure 1. Intraoperative photograph of the right eye showing opacification of
Akreos Adapt ® IOL. The arrows show the edges of the opacified area of IOL.
CASE REPORT
 Postoperatively, the patient did not exhibit
specific complications and the visual acuity was
improved to 0.04
 6 months postoperatively, the corrected visual
acuity was maintained as 0.06 due to macular
edema
DISCUSSION
 Exchange of IOL d/t the postoperative
opacification has been reported
 Hydroview® (Bausch & Lomb)
 ACRL-60 (Ophthalmed Inc.)
 MemoryLens® (Ciba Vision)
 AquaSense® (Ophthalmic Innovations International)
 SC60B-OUV (Medical Developmental Research)
 Centerflex® 570H (Rayner)
* Akros Fit® (Bausch & Lomb) : no clinically notable
decrease of VA, exchange of IOL was not performed
DISCUSSION
 Unfortunately histopathological assessments
was not performed
 Deposition of minerals including Ca2+ on the
surface of optical part is assumed to be the
causative factor
 28-year-history of diabetes & inflammatory
responses due to hyphema developed during
the clinical course of patients affected the
opacification of IOLs
CONCLUSION
 We report our case of the opacification of
hydrophillic IOLs (Akreos Adapt®, Bausch &
Lomb) which was not reported previously
 In patients with DM, the substances forming
IOLs must be considered for cataract surgery
 Further histopathological studies are warranted
to analyze the causes of opacification of
hydrophilic Akreos intraocular lens
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