Opacification of an accommodative silicone intraocular lens in asteroid hyalosis

Abstract

A case of opacification of an accommodating silicone intraocular lens (IOL) (Crystalens AO) in a patient with asteroid hyalosis (AH) is presented. A review the literature on dystrophic calcification of silicone IOLs and suggested management for improving visual symptoms in patients with this complication is discussed. Pathology of the explanted IOL of a 57-year-old man confirmed the presence of calcium. A review of the literature disclosed 37 other cases (eyes) of dystrophic calcification in the context of AH. Various IOL designs and manufacturers were reported. Of the 37 cases reported, none included an accommodating silicone IOL implant. To the authors′ knowledge, this is the first reported case of an accommodating silicone IOL to opacify in the presence of AH. Based on the literature review, silicone IOLs are at risk for opacification and should be avoided or used with extreme caution in patients with AH. In addition, YAG capsulotomy might hasten posterior IOL calcification, rendering IOL exchange more challenging.