1. Opacification of the optic of an Akeos Adapt® intraocular lens
Chong Eun Lee, MD, Sung Dong Chang, MD, PhD
Department of Ophthalmology, School of Medicine,
Dongsan Medical Center,
Keimyung University, Daegu, Korea
The authors have no financial interest

2. INTRODUCTION
The opacifications of intraocular lens, causing the removal or exchange of implanted intraocular lens, have been reported to occur in some hydrophilic acrylic intraocular lens (IOL)
We experienced a case of the opacification of hydrophillic intraocular lens (Akreos Adapt ®, Bausch & Lomb)
To our knowledge, there was no prior report of an opacification in that IOL

3. CASE REPORT 55-year-old man 28-year-history of diabetes mellitus (DM)
Also receiving peritoneal dialysis for chronic renal failure
Two months before, at other eye hostpital
pars plana vitrectomy, panretinal photocoagulation
(for proliferative diabetic retinopathy)
phacoemulsification & implantation of hydrophillic acryl intraocular lens in the capsular bag
(Akreos Adapt ®, Bausch & Lomb)

4. CASE REPORT
At the time of the first visit, the patient presented with proliferative diabetic retinopathy in both eyes and clinically significant macular edema
Initial best corrected visual acuity (OD) : 0.08
Four months later
BCVA (OD) finger count 10 cm
Intraocular pressure (OD) 38 mmHg
Rubeosis c hyphema in the right eye
Dx. : neovascular glaucoma (OD)

5. CASE REPORT Ahmed valve implantation(OD) through pars
plana, at our hospital
5 months following the surgery of glaucoma
(10 months following the implantation of IOL)
BCVA (OD) 0.08
Microhyphema still present
IOL opacification found

6. CASE REPORT 45 months following the implantation of IOL
BCVA (OD) hand motion
disappearance of hyphma
IOL opacification causing a decreased VA was found
(Figure 1)
IOL was explanted from the right eye &
Hydrophobic acrylic IOL, YA-60BB (HOYA®,
Japan), was implanted into the sulcus

7. Figure 1. Intraoperative photograph of the right eye showing opacification of
Akreos Adapt ® IOL. The arrows show the edges of the opacified area of IOL.

8. CASE REPORT
Postoperatively, the patient did not exhibit specific complications and the visual acuity was improved to 0.04
6 months postoperatively, the corrected visual acuity was maintained as 0.06 due to macular edema

9. DISCUSSION Exchange of IOL d/t the postoperative
opacification has been reported
Hydroview® (Bausch & Lomb)
ACRL-60 (Ophthalmed Inc.)
MemoryLens® (Ciba Vision)
AquaSense® (Ophthalmic Innovations International)
SC60B-OUV (Medical Developmental Research)
Centerflex® 570H (Rayner)
* Akros Fit® (Bausch & Lomb) : no clinically notable
decrease of VA, exchange of IOL was not performed

10. DISCUSSION Unfortunately histopathological assessments
was not performed
Deposition of minerals including Ca2+ on the surface of optical part is assumed to be the
causative factor
28-year-history of diabetes & inflammatory
responses due to hyphema developed during the clinical course of patients affected the
opacification of IOLs

11. CONCLUSION
We report our case of the opacification of hydrophillic IOLs (Akreos Adapt®, Bausch & Lomb) which was not reported previously
In patients with DM, the substances forming
IOLs must be considered for cataract surgery
Further histopathological studies are warranted to analyze the causes of opacification of hydrophilic Akreos intraocular lens

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