Once In A Blue Moon: Unexpected Complication Of Phaco Surgery

to report an exceptionnal peroperative complication of cataract surgery through the description of a clinical case 

cataract surgery is now the most common surgical procedure performed in the world, despite ongoing advances in cataract surgical technology, a small number of complication will always exist. opacification of the intra ocular lens is one of the rarest complications that may occur, even exceptionnal when it is acute.

uneventful cataract surgery was performed on the left eye of an 64 year old diabetic man. a foldeble hydrophilic acrylic intraocular lens (IOL, manifactured by: CAREGROUP SIGHT SOLUTION PRIVATE LIMITED) was implanted in the bag. we were just about to seal the incisions, we noticed sudden cloudy IOL. however, the lens was not changed, and the whitish aspect disapeared the following day, and it stayed clear after 6 months’ follow-up.

the opacification of hydrophilic acrylic IOL is a rare complication usually occurring in the late posteperative period. the exact causes and pathomechanisms leading to opacification is unknown. in our case, under topical anesthesia, the phacoemulsification surgery using the stop and shop technique was uneventful, we used viscoelastic hyaluronate(2%), balanced sel serum and intracameral cefuroxime(1mg/0.1ml). we made sure to investigate the cause of opacification and we found that the IOL was kept in a cold storage making the rapide temperature change a probable mechanism of the acute opacification of the lens. 

acute opacification of hydrophilic acrylic lens is a very rare phenomenon, in the light of this presented case, we tend to highlight the importance of appropriate storage of the IOLs to prevent sudden temperature change of the lens during implantation. also, we find that immediate IOL exchange is unecessary as it clears up spontaneously.