Intraoperative crystallization on the intraocular lens surface - 09/09/11
Abstract |
PURPOSE: To report a physician survey, laboratory studies, and clinical observations of intraoperative crystallization on the surface of the intraocular lens (IOL).
METHOD: We sent a survey to all ophthalmologists in the states of Wyoming, Idaho, Montana, Utah, and Colorado asking whether crystallization on the IOL surface had occurred in any of their patients and what viscoelastics, IOLs, and other solutions were used. All returned surveys were tabulated and analyzed by standard statistical means. A sample of crystallization from an IOL on a glass slide submitted by a physician was analyzed to ascertain the relative elemental composition. During in vitro laboratory studies, BSS Plus (Alcon Surgical, Fort Worth, Texas) and BSS (Alcon Surgical) were measured and analyzed for precipitation. Healon GV (Pharmacia/Upjohn, Kalamazoo, Michigan) and calcium chloride were combined in various solutions and examined for precipitate formation. Silicone IOLs and plate silicone were placed in different BSS and BSS Plus solutions with different viscoelastics and varying calcium concentrations. In seven patients, prominent crystallization on an IOL surface was examined, photographed, and followed for up to 3 years.
RESULTS: Two hundred six surveyed ophthalmologists returned 181 surveys (88%) and reported 29,609 cataract surgeries, with IOL implantation with 22 eyes (0.07%) (22 patients) in which intraoperative crystallization was observed on the IOL surface during 1993. The survey indicated there was a correlation with BSS Plus (chi-square = 4.9, P = .0268) and silicone IOLs (chi-square = 6.8, P = .0093). The sample showed the cation to be calcium.
CONCLUSION: Crystallization on the IOL surface during cataract surgery is a rare occurrence that may be associated with calcium as the cation related to an osmotic gradient around the IOL with increased calcium concentration. If encountered surgically, the lens should be exchanged in the operating theater after irrigating the anterior chamber with BSS and completely filling the capsular bag with a low molecular weight viscoelastic.
Le texte complet de cet article est disponible en PDF.Plan
 | Supported in part by a grant from Research to Prevent Blindness, Inc, New York, New York, to the Department of Ophthalmology, University of Utah. |
Vol 126 - N° 2
P. 177-184 - août 1998 Retour au numéro
Article précédent
- Granular corneal dystrophy with homozygous mutations in the kerato-epithelin gene
- Masaki Okada, Shuji Yamamoto, Hitoshi Watanabe, Yoshitsugu Inoue, Motokazu Tsujikawa, Naoyuki Maeda, Yoshikazu Shimomura, Kohji Nishida, Shigeru Kinoshita, Yasuo Tano
- Five-year results of a randomized, prospective, clinical trial of diode vs argon laser trabeculoplasty for open-angle glaucoma
- Paul Y Chung, Joel S Schuman, Peter A Netland, Rhea A Lloyd-Muhammad, Deborah S Jacobs
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?