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First Author: A.Yaman TURKEY
Co Author(s): D. Er T. Ozturk H. Oner
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To report opacification of intraocular lenses (IOLs) after pars plana vitrectomy surgery with silicone oil injection.
Retrospective case series.
Eight eyes of 8 patients who referred to our clinic between January 2009 and March 2013 with late IOL opacification after standart 20 Gauge pars plana vitrectomy surgery with silicone oil injection were enrolled. All of the patients had an uneventful phacoemulsification surgery with hidrophilic acrylic IOL implantation before the retinal surgery; and all of the study eyes faced with late IOL opacification after silicone oil removal. The ophthalmologic examination including testing for best corrected visual acuity (BVCA), slit-lamp biomicroscopy, ocular tonometry and dilated fundoscopy was performed in all cases. The diagnosis of IOL opacification was based on clinical features by slit-lamp evaluation through dilated pupil. Three eyes (37.5%) with significantly diminished visual acuity related with IOL opacification underwent surgery for IOL exchange.
Of the 8 participants with the mean age of 51.7ḟ15.2 years (29-71), 4 were females and 4 were males. Preoperative diagnosis before retinal surgery were high myopia in 4 eyes (50%), pseudophakic retinal detachment in 3 eyes (37,5%), and penetrating eye injury in 1 eye (12,5%). Mean follow-up time was found as 28ḟ12 months (12-48), however silicone oil was removed after the mean of 9.25ḟ3.24 months (514). The mean BCVA before silicone oil injection was logMAR 2.51ḟ1.09 whereas it was found as logMAR 1.28ḟ1.13 logMAR after silicone oil injection. Study patients had suffered from decreased BCVA and glare at the mean of 28.6ḟ14.6 months after pars plana vitrectomy with silicone oil injection, and the mean BCVA was found as logMAR 2.12ḟ1.06 at the time of the diagnosis of IOL opacification. In 3 cases, IOL exchange surgery was performed because of the visual disturbances caused by postoperative deposits on the optic surface of the IOLs.
Clinically significant opacification of the IOLs may be caused by various pathologic processes. One of which is silicone oil that may lead a slow, progressive degradation of the IOL biomaterial. Irreversible adherence of silicone oil to the optic surface of the IOL material may also cause serious visual impairment.