Multiple Pit Defects of Unknown Etiology in a Foldable Hydrophobic Intraocular Lens.

PRESENTATION

A 56-year-old female patient presented to our clinic for a routine follow-up appointment after penetrating keratoplasty and cataract surgery (triple procedure) for a deep corneal scar due to previous herpetic keratitis. The procedure was performed 9 months before the recent presentation. Her unaided visual acuity was 2/10 OD and 10/10 OS. On slit-lamp examination, the corneal graft OD appeared clear, and the anterior segment OS was healthy with bilateral pseudophakia. However, we unexpectedly observed that there were multiple pits on the anterior surface of the intraocular lens (IOL) OD [Figure 1], which was a hydrophilic, one-piece, in-the-bag IOL. The patient did not undergo any YAG capsulotomy or vitrectomy with silicone oil tamponade. She had not experienced any intraocular infection or corneal graft rejection episodes since undergoing ocular surgery.

Figure 1

Slit-lamp photograph of the right eye. A clear corneal graft with interrupted corneal sutures was noted. The anterior chamber was deep and quiet. The intraocular lens shows multiple pit defects.

DISCUSSION

There are various reasons that could lead to the formation of pits on IOLs. The most common cause of pits is obviously YAG laser capsulotomy,[1] followed by silicone oil tamponade in vitrectomized eyes.[2] Asteroid hyalosis has also been implicated in pit formation, particularly in silicone IOLs.[3] Moreover, pits have also been described in hydrophilic IOLs, presumably caused by hydration of the IOL in the presence of a manufacturing IOL defect.[4] To our knowledge, this is the first case of spontaneous, multiple pits on a hydrophobic IOL without any obvious underlying cause.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understand that her name and initial will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.