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PHOTO ESSAY
Year : 2020  |  Volume : 68  |  Issue : 1  |  Page : 190-191

Inflammatory deposits on the foldable intraocular lens


Department of Uvea and Intraocular Inflammation, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India

Date of Submission24-Jul-2019
Date of Acceptance28-Aug-2019
Date of Web Publication19-Dec-2019

Correspondence Address:
Dr. Parthopratim Dutta Majumder
Department of Uvea, Sankara Nethralaya, 18, College Road, Nungambakkam, Chennai - 600 006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1359_19

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  Abstract 


Keywords: Inflammatory giant cell deposits, IOL deposits, IOL histopathology


How to cite this article:
Shah A, Rao C, Kumar K, George RJ, Dutta Majumder P. Inflammatory deposits on the foldable intraocular lens. Indian J Ophthalmol 2020;68:190-1

How to cite this URL:
Shah A, Rao C, Kumar K, George RJ, Dutta Majumder P. Inflammatory deposits on the foldable intraocular lens. Indian J Ophthalmol [serial online] 2020 [cited 2020 Aug 8];68:190-1. Available from: http://www.ijo.in/text.asp?2020/68/1/190/273191



A 59-year-old female presented with visual acuity of 6/18, N8 in her left eye, 10 years after combined cataract and glaucoma surgery. Slit-lamp examination revealed a quiet eye with multiple deposits on the intraocular lens (IOL) which could not be removed by YAG laser or manual scraping [Figure 1]a. Histopathological evaluation of explanted IOL revealed multiple histiocytes on the optic surface and multinucleated giant cells on the haptic surface [Figure 1]b, [Figure 1]c, [Figure 1]d. Giant cells, visible on slit lamp as sharp, round, or oval spots with or without pigmentation, usually occur within 2 years after implantation.[1]
Figure 1: (a) Slit-lamp photograph showing sharp white round deposits within the IOL optic (b) Optic and haptic surface showing chronic granulomatous inflammation (Hydrophilic Acrylic IOL with plate loop haptics; H and E stain; original magnification 10×). (c and d) Optic surface showing numerous histiocytic cells and haptic showing numerous multinucleated giant cells; H and E stain; original magnification 400× and 500×)

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  Discussion Top


The most conspicuous factor in the development of an inflammatory giant cell reaction, after combined cataract and glaucoma surgery, is IOL design whereby silicone plate IOLs show greater reaction compared with 3-piece acrylic IOLs.[2] Increased intraoperative manipulation involved in combined surgery is responsible for these inflammatory deposits, hence the choice of IOL becomes extremely important in such cases. IOL removal is imperative when they become visually significant.

Declaration of patient consent

A written informed consent was taken from the patient. Ethics committee approval was obtained.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Wolter JR. Foreign body giant cells on intraocular lens implants. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol 1982;219:103-11.  Back to cited text no. 1
    
2.
Samuelson TW, Chu YR, Krieger RA. Evaluation of giant-cell deposits on foldable intraocular lenses after combined cataract and glaucoma surgery. J Cataract Refract Surg 2000;26:817-23.  Back to cited text no. 2
    


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