Is It A New Wave Of Cataract?

to study the possible causes and risk factors involved in an epidemic of opacified intraocular lenses (IOL) discovered in a tertiary eye hospital.

tertiary hospital setting

All opacified IOL cases were reviewed. Review of clinical details of cases of opacified IOLs was done. Variables collected included the presence of systemic diseases, ocular diseases, type of primary surgery and IOL used, secondary intervention, and time to secondary intervention in addition to type of opacified IOL.

The total number of cases were 45. Mean patient age was 49.69±21.4 years. Diabetes was present in 45% of cases with an average disease duration of 19 years. Sixty percent of those diabetics were insulin-dependent. Silicone oil tamponade was used in 36% of cases. Primary surgery was phaco alone in 55%, pars plana vitrectomy combined with phaco in 27%, and silicone oil removal combined with phaco in 18% of cases. Seven IOLs were a similar lot number and another four also having the same lot number. Average interval to secondary surgery was 1.7±0.4 years. Secondary surgery involved opacified IOL explantation, insertion of either a PMMA (36%) or a 3-piece foldable IOL (64%) with or without anterior vitrectomy.

Specific IOL types may be prone to opacification and require long-term follow-up to detect this complication. Diabetes, type of surgery, silicone oil tamponade, or IOL manufacturing defect may be responsible for opacification.