Intraoperative Opacification of a hydrophilic acrylic with hydrophobic surface IOL with spontaneous resolution in 24 hours

Purpose: To report an intraocular lens opacification case during cataract surgery.

Methods: An 80-year-old woman with a history of hypertension and type 2 diabetes mellitus presented with advanced nuclear cataract in her left eye and underwent coaxial phacoemulsification through a 1.8-mm micro-incision and insertion of an in-the-bag intraocular lens (IOL). There was subsequently rapid, homogenous, and complete opacification of the lens, which remained opaque for 2 hours postoperatively. At 24 hours postoperatively, the IOL was transparent with no signs of opacification and the only findings were moderate corneal edema and mild remains of sub-incisional cortex. At the last postoperative visit 1 month after surgery, the IOL remained clear and the visual acuity was 20/20. The same conditions were reproduced in vitro and the same complete and homogenous opacification of the lens was observed.

Results: After an extensive review of the literature about other IOL opacification cases reported, no previously published case related to this condensation was found.

Conclusion: The description of the temporary IOL opacification phenomenon due to condensation could be useful to cataract surgeons, who might avoid cold storage of IOLs. The known self-resolution of this type of IOL opacification makes advisable to delay IOL surgical explantation in these cases.