case_images: PMC10964437_01
case_images: Slit lamp photographs of the patient implanted with the SC60B-OUV IOL 23 years after implantation. (a) Note the opacity present on the anterior surface of the optic of this lens. (b) A central grayish opacity involves the optic area of the IOL. Postoperative fibrosis of the anterior capsule is seen at the capsulorhexis margin, which is greater than the diameter of the opacity. (c) The red reflex assessment of the dilated eye with a slit lamp examination shows that the central opacity is similar to a white cataract. (d) A gross photograph of the explanted SC60B-OUV lens demonstrates a circular area of white opacification in the central optic and an opacified band of approximately 1.0 mm at 360 . (d) A gross photograph of the explanted SC60B-OUV lens demonstrates a circular area of white opacification in the central optic and a milder opacified band of approximately 1.0 mm at 360 . In addition, it has a haptic clear, while the other has various degrees of opacification.. IOL, acrylic intraocular lens.
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case_images: The opacification had a very well-demarcated and round edge in the central optic zone of the IOL, similar to a white cataract [Figure 1(a) and (b)]. According to the red reflex assessment of the dilated eye by retro-illumination on slit lamp examination, the edges of the optic and the haptics appear transparent [Figure 1(c)]. IOL showed a dense well-circumscribed opacification confined to the central 4 mm of the optic with a milder opacification of the edges of the IOL and clear haptics [Figure 1(d)]. Images from calcified IOLs similar to our SC60B-OUV IOL have been described by several researchers.
case_images: (a) SEM of the lens's central optic area (2380x) reveals folds on the anterior surface (white arrows) and two deposits that resemble calcium phosphate salts (scale bar: 5 mum). (b) Energy-dispersive spectroscopy microanalysis over the length of the arrow line (a) shows OCP deposits formed on the anterior surface of the IOL. (c) SEM of the anterior surface of the lens shows crystalline deposits (scale bar: 10 mum). (d) Energy-dispersive spectroscopy microanalysis of the calcific deposits shows DCPD, OCP, and HAP. Both OCP and HAP are from the hydrolysis of DCPD.. DCPD, dicalcium phosphate dihydrate; HAP, hydroxyapatite; IOL, acrylic intraocular lens; OCP, octacalcium phosphate; SEM, scanning electron microscopy.
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case_images: IOL showed that the deposits consisted of calcium and phosphorus [Figure 2(a) and (b)] forming platy crystals on the anterior surface of the opacified IOL. In Figure 2(c) and (d), these crystals showed clearly that they consisted of dicalcium phosphate dihydrate (DCPD) and octacalcium phosphate (OCP) crystallites. IOL showed numerous folds on its anterior surface [Figure 2(a)]. IOL anterior surface folds were present throughout the optic diameter of the IOL but were more pronounced and dense in the area of the capsulorhexis.
case_images: (a, b) SEM images show large crystallites of DCPD and OCP transient phase and thermodynamically stable HAP nanocrystallites [scale bar: 1 mum in both (a) and (b)]. (c) An SEM image shows folds (arrows) and a few calcific deposits. (d) Energy-dispersive line scan microanalysis of deposits confirmed the formation of HAP crystals.. DCPD, dicalcium phosphate dihydrate; HAP, hydroxyapatite; OCP, octacalcium phosphate; SEM, scanning electron microscopy.
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case_images: The morphology of DCPD and OCP, which are transient calcium phosphate phases hydrolyzed to the thermodynamically more stable hydroxyapatite (HAP), is shown in Figure 3.
case_images: (a) SEM image from the anterior optic surface of the explanted opacified IOL showing numerous folds of the surface and sporadic calcific deposits (scale bar: 10 mum). (b) Higher magnification of the above image (scale bar: 2 mum). (c) SEM image and (d) energy-dispersive spectrometric microanalysis along the length of the arrow line (c) shows HAP formed with a scattered pattern on the anterior surface of the IOL.. HAP, hydroxyapatite; IOL, acrylic intraocular lens; SEM, scanning electron microscopy.
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case_images: Despite that, the presence of calcium phosphate deposits on the surface of the IOL was limited to the area of capsulorhexis (Figure 4).