CRYSTALLIZATION WITHIN INTRAOCULAR LENS MATRIX

Julie Tyler

Abstract

BACKGROUND: A variety of complications associated with
cataract surgery are commonly encountered in
clinical practice. However, relatively few of
these complications are attributed to the
intraocular lens itself. Far fewer can be
linked to transparency of the intraocular lens
material.

CASE REPORT(S). An 83 year-old white male presented with
complaints of blurry vision with distortion
around lights, especially at night, OU. He had
been told previously that his posterior chamber
intraocular lenses (IOL's), which were placed 15
years prior, were "deteriorating." He had a
complex medical history, which included
hypertension, hypercholesteremia, cardiac
arrhythmia, poor peripheral vascular perfusion,
and polymyalgia. Medications included Zocor and
Monopril (for three months), coumadin
intermittently, amiodarone for six years,
and prednisone for 20 years. Visual acuity was
reduced to 20/40 OD and 20/30 OS, which was
attributed to a remarkable polychromatic
crystallization within the entire thickness of
each IOL. The Optex UV301-03 IOL's were
well-centered. Bilateral vortex keratopathy
secondary to amiodarone was also noted. The
remainder of the ocular health examination was
unremarkable save for an abundance of large
sebaceous cysts involving the ocular adnexa of
both eyes.

CONCLUSIONS. Although the effects of some systemic drugs on
the cornea and anterior lens surface are
well-documented, the peculiar through-and-through
crystallization in this case was unexpected. Our
discussion will include suspected etiologies for
this unusual finding, including the possibility
that the crystals were formed as a result of the
patient's long history of prednisone and/or
amiodarone therapy. In addition to detailed case
report information and clinical photographs, we
will present a brief review of intraocular lens
materials and their relevant characteristics.
Finally, a summary of common ocular effects of
systemic drugs is included.

Details

Year: 2001

Program Number: Poster 147

Author Affiliation: Nova Southeastern University College of Optometry

Co-Authors: Kimberly Reed, Alexandra Espejo

Co-Author Affiliation: Nova Southeastern University Health Sciences Division

Room: Exhibit Hall C