Diffuse punctate deposits on the surface of hydrophilic acrylic intraocular lenses early postoperatively: case series and laboratorial analyses.

Purpose: To describe cases of hydrophilic acrylic intraocular lenses (IOLs) (Eyecryl, Biotech) exhibiting surface punctate deposits early postoperatively and provide laboratorial analyses of unused lenses of the same model.

Setting: Altino Ventura Foundation (FAV), Recife, Brazil, and John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.

Design: Observational, descriptive, clinical study with laboratorial analysis.

Methods: A thorough review of records of patients undergoing phacoemulsification with Eyecryl implantation in December 2022 at FAV was performed, with data collection. 5 Eyecryl IOLs (never implanted/unused) were removed from the original package and underwent gross examination, light microscopy, and ultrastructural analyses using scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS).

Results: Details on 5 clinical cases exhibiting surface IOL deposits on the first postoperative day after uneventful surgery and followed for at least 6 months were included. The deposits disappeared by the 60th postoperative day. No inflammatory or toxic reactions were noted, visual outcomes were favorable, and IOL explantation was not necessary. 3 of the 5 unused lenses undergoing laboratorial analyses revealed diffuse, star-like deposits that could not be removed by thorough irrigation with distilled water. SEM/EDS revealed a composition of the deposits that primarily consisted of carbon and oxygen.

Conclusions: Laboratorial findings suggest the etiology of the deposits might be related to the manufacturing/packaging process of lenses from specific lots. Although the deposits did not appear to be associated with inflammatory or toxic reactions in the clinical cases, further investigations are necessary to elucidate their precise origin.