PURPOSE: To describe the clinical and microscopic findings in 2 different patients of 2 cases of late opacification of the hydrophilic acrylic intraocular lens (IOL) Ioflex. METHODS: Two eyes of 2 patients (73 and 74 years old) had an uneventful phacoemulsification surgery with implantation of the Ioflex IOL (power +21.5 D). At 5 years after surgery, a dense IOL opacification was detected in both cases with significant visual degradation. The IOLs were explanted and analyzed by microscopy. RESULTS: In both cases, a satisfactory visual recovery was achieved (corrected distance visual acuity of 6/9 and 6/12). Microscopic examination of the explanted IOLs revealed multiple small granules on the surface/subsurface of the lens. Although histochemical or surface analyses were not performed, the aspect appears consistent with a process of calcification of this lens design. Other findings included few surface contaminants, such as fibers, crystals that may correspond to dry viscoelastic and/or salt solutions, as well as pigments and dust-like deposits. CONCLUSIONS: Opacification of the posterior chamber hydrophilic acrylic IOL Ioflex probably related to calcification can appear several years after its implantation and requires IOL exchange due to the significant visual loss induced. More studies are required to understand the causes of this complication.

Departament de Optics Pharmacology and Anatomy University of Alicante Alicante Spain

Department of Ophthalmology Medical Faculty of Charles University Prague Czech Republic Teaching Hospital Kralovske Vinohrady Prague Czech Republic

Eye Department Regional Hospital Havlickuv Brod Havlickuv Brod Brod Czech Republic Department of Ophthalmology Medical Faculty of Charles University Prague Czech Republic

John A Moran Eye Center University of Utah Salt Lake City UT USA Berlin Eye Research Institute Berlin Germany

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