A unique late-onset intraocular lens opacification 23 years after implantation: a clinical and laboratory case report.

IF 2.3 Q2 OPHTHALMOLOGY Therapeutic Advances in Ophthalmology Pub Date : 2024-03-25 eCollection Date: 2024-01-01 DOI:10.1177/25158414241237713

Panos S Gartaganis, Panagiota D Natsi, Sotirios P Gartaganis, Petros G Koutsoukos, Horst Helbig

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Abstract

We report an unusual, rare case of opacification of the hydrophilic acrylic intraocular lens (IOL) 23 years after the initial surgery with significant visual deterioration. Opacification of the hydrophilic acrylic IOL was primarily due to the formation of folds on the surface of the lens material, and less so due to calcium phosphate deposits. Calcification opacification can be attributed to recent events, as evidenced by deposits of dicalcium phosphate dihydrate (CaHPO₄2H₂O) and octacalcium phosphate (Ca₈H₂(PO₄)₆5H₂O), both of which are transient calcium phosphate phases, converting hydrolytically to the thermodynamically most stable hydroxyapatite (Ca₁₀(PO₄)₆(OH)₂). To our knowledge, this case of hydrophilic acrylic IOL opacification is the only one that has been described so late, 23 years after cataract surgery.

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眼内晶状体植入 23 年后出现独特的晚发性眼内晶状体混浊：临床和实验室病例报告。

我们报告了一例不寻常的罕见病例，患者在初次手术后 23 年，亲水性丙烯酸人工晶体（IOL）发生了混浊，视力严重下降。亲水性丙烯酸人工晶体的不透明主要是由于晶状体材料表面褶皱的形成，较少是由于磷酸钙沉积。钙化不透明可归因于近期发生的事件，二水磷酸二钙（CaHPO42H2O）和磷酸八钙（Ca8H2(PO4)65H2O）的沉积就是证明，这两种磷酸钙都是瞬时磷酸钙相，会水解转化为热力学上最稳定的羟基磷灰石（Ca10(PO4)6(OH)2）。据我们所知，这例亲水性丙烯酸人工晶体不透明是唯一一例在白内障手术后 23 年才出现的不透明病例。

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