Department of Ophthalmology, CHA Bundang Medical Center, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam, Gyeonggi 463-712, Korea.
Jpn J Ophthalmol. 2011 Nov;55(6):595-9. doi: 10.1007/s10384-011-0074-7. Epub 2011 Aug 31.
To report clinicopathologic and ultrastructural feature of one opacified hydrophilic acrylic intraocular lens (IOL) explanted from a diabetic patient.
A 48-year-old man underwent trans pars plana vitrectomy and phacoemulsification with implantation of a hydrophilic acrylic lens OS in November 2008. The patient complained of a marked decrease in visual acuity in May 2009 as a result of a milky opalescence of the IOL. Intraocular lens explantation and exchange were performed in August 2009, and the explanted IOL was submitted to our center for detailed pathologic, histochemical and ultrastructural evaluation. It was stained by the von Kossa method for calcium, and also underwent scanning electron microscopy and energy dispersive radiograph spectroscopy to ascertain the nature of the deposits leading to opacification.
Opacification of the IOL was found to be the cause of the decreased visual acuity. The opacification involved only the IOL optic, and the haptics was clear. Histochemical and ultrastructural analyses revealed that the opacity was caused by deposition of calcium and phosphate within the lens optic.
We believe this report of calcification of the Akreos(®) MI-60 IOL is of clinicopathological importance. Long-term follow-up of diabetic patients implanted with this IOL should be maintained by surgeons and manufacturers.
报告一例从糖尿病患者眼内摘除的不透明亲水性丙烯酸人工晶状体（IOL）的临床病理和超微结构特征。
一名 48 岁男性于 2008 年 11 月接受经睫状体平坦部玻璃体切除术和超声乳化白内障吸除术，并在右眼植入亲水性丙烯酸晶状体。2009 年 5 月，患者因 IOL 呈乳白色混浊而出现明显视力下降，随后接受了眼内晶状体摘除和置换术。2009 年 8 月，我们对所摘除的 IOL 进行了详细的病理、组织化学和超微结构评估。该 IOL 采用 von Kossa 法进行钙染色，并进行了扫描电子显微镜和能谱分析，以确定导致混浊的沉积物的性质。
IOL 混浊是导致视力下降的原因。混浊仅累及 IOL 光学部，襻清晰。组织化学和超微结构分析显示，混浊是由于晶状体光学部内钙和磷酸盐的沉积所致。
我们认为，本报告中 Akreos® MI-60 IOL 的钙化具有临床病理意义。植入这种 IOL 的糖尿病患者应保持由外科医生和制造商进行长期随访。
