Introduction. The aim of this study was to report clinical and pathological features of hydrophilic acrylic intraocular lenses (IOLs) of two different one-piece designs, explanted from patients who had visual disturbances caused by opacification of the lens optic.

Material and Methods. Thirty-five hydrophilic acrylic IOLs (33 SC60B-OUV and 2 AquaSense lenses) were explanted and sent to our center. Most patients became symptomatic during the second year after cataract surgery. A clouding or haze was observed within the optic of the lenses. The opacity clinically resembled a nuclear cataract. Gross examination, light microscopy and staining with alizarin red and the von Kossa method (for calcium) were performed. Some lenses were submitted for scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS).

Results. Light microscopic and SEM analyses revealed that the opacity was caused by the presence of multiple fine, granular deposits within the lens optic, distributed in a line parallel to the anterior and posterior curvatures of the optic, with a clear zone just beneath its external surfaces. The deposits in all cases stained positive with alizarin red and the von Kossa method. EDS also demonstrated the presence of calcium and phosphates within the deposits. In some cases, the opacity extended towards the haptics. In 3 cases, the lenses were completely opacified. Calcium deposits on the optical surfaces of the lenses were also present in some cases.

Discussion/Conclusion. Careful clinical follow up of patients implanted with these lenses is necessary to determine if this phenomenon is rare and sporadic or may be more widespread.