IOL opacification/ Glistening
Several types of IOLs have developed opacities or discoloration either immediately after implantation or progressively over the years.
5 processes of IOL opacification are:
• deposits or precipitates on the surface of or within the IOL
• influx of water in hydrophobic optic material (glistenings)
• IOL staining by capsular dyes or medications
• IOL coating by substances such as ophthalmic ointment or silicone oil
• progressive degradation of the IOL material (eg, snowflake degeneration in PMMA IOLs)
-Calcium deposition on the surface of or within hydrophilic acrylic lenses can degrade the quality of vision, and IOL explantation may be required
-Calcium deposits on silicone lenses can be seen in eyes with asteroid hyalosis, usually after posterior capsulotomy
-Glistenings are fluid- filled microvacuoles that form within an IOL optic in an aqueous environment
-They are observed within all IOL materials but are typically associated with certain hydrophobic acrylic IOLs
-Glistening formation and intensity increase with time
-Although their appearance may be striking on slit- lamp examination, glistenings do not usually affect visual acuity
-They can have a negative effect on contrast sensitivity at high spatial frequency
-However, IOL explantation for glistenings is rarely reported
-IOL explantation has been required when interlenticular opacification occurred between piggyback PCIOLs, especially when both lenses were made of hydrophobic acrylic material and were placed in the capsular bag
-Using IOLs made of 2 different materials, enlarging the capsulorrhexis, and placing 1 lens in the capsular bag and 1 in the sulcus may reduce the incidence of opacification
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Image from Rajan Eye Care Hospital
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