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Calcification of hydrophilic acrylic intraocular lenses following secondary surgical procedures in the anterior and posterior segments
  1. Kieren Darcy1,
  2. Andrew Apel2,3,
  3. Mark Donaldson2,3,
  4. Robert McDonald4,5,
  5. John Males5,6,
  6. Michael Coote7,8,
  7. Liliana Werner9,
  8. Elsie Chan7,8
  1. 1 Bristol Eye Hospital, Bristol, UK
  2. 2 Ophthalmology, Princess Alexandra Hospital, Woolloongabba, Brisbane, Australia
  3. 3 Ophthalmology, University of Queensland, Brisbane, Australia
  4. 4 Sydney Eye Hospital, Sydney, New South Wales, Australia
  5. 5 University of Sydney, Sydney, New South Wales, Australia
  6. 6 Save Sight Institute, Sydney, Australia
  7. 7 Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  8. 8 Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
  9. 9 University of Utah, Salt Lake City, Utah, USA
  1. Correspondence to Dr Elsie Chan, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia; elsie.chan{at}


Aims To report 15 cases of intraocular lens (IOL) calcification following intraocular surgery and to identify common risk factors.

Methods A retrospective case review of patients with IOL calcification reported from the Royal Victorian Eye and Ear Hospital, Melbourne, Australia, and six surgeons in private practice in the Australian states of Victoria, New South Wales and Queensland.

Results 15 cases of IOL calcification were identified. Eight cases were in hydrophilic acrylic IOLs and seven in hydrophilic acrylic IOLs with hydrophobic surface properties. Five cases occurred following intraocular injection of gas during endothelial keratoplasties. Two cases occurred following pars plana vitrectomy where gas was used. The remaining eight cases did not involve the injection of any intraocular gas; six cases were following trabeculectomy surgery, and two cases were after insertion of a ‘piggyback’ sulcus IOL. In each case, the calcification had a characteristic pattern, being centrally placed in the pupillary zone, mainly affecting the anterior lens surface.

Conclusion The aetiology of IOL calcification is not fully understood, although there are known risk factors such as using hydrophilic acrylic materials and the use of intraocular gas. Surgical consideration of a patient’s ocular comorbidities before IOL implantation is an important tool to mitigate some of this risk.

  • intraocular lens opacification
  • endothelial keratoplasty
  • trabeculectomy
  • vitrectomy

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  • Contributors KD and EC were involved in the conception of the work, interpretation of data, drafting the manuscript, revising the manuscript and in the final approval process. AA was involved in the conception of the work, interpretation of data, revising the manuscript and in the final approval process. MD, RM, JM, MC and LW were involved in the interpretation of data, revising the manuscript and in the final approval process.

  • Funding LW is supported in part by an unrestricted grant from Research to Prevent Blindness, New York, New York, USA to the Department of Ophthalmology and Visual Sciences, University of Utah.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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