There are times when certain hydrophilic acrylic IOLs end up become opaque with time. This is thought to be a multifactorial process whereby calcium deposits cause the optic to become opacified. Intra-ocular gas use (such as for corneal lamellar transplantation or vitrectomy), certain viscoelastics, and other factors have been implicated. The bottom line is that the opacified IOL has to be explanted and exchanged for a new IOL with a clear optic, most often a hydrophobic acrylic design IOL. Have you encountered a case like this and what are your thoughts behind the pathogenesis?
