A 55-year-old diabetic patient who had pars plana vitrectomy with silicone oil tamponade followed later by phacoemulsification with a hydrophilic acrylic IOL returns 18 months later with a milky-white opacified lens implant. The mechanism of this IOL opacification is:

• A Growth of water-filled microvacuoles within the optic
• B Absorption of silicone oil droplets into the haptics
• C Nd:YAG-induced pitting of the optic surface
• D Calcium phosphate deposits within the hydrophilic polymer matrix ✓

Explanation

Hydrophilic acrylic lenses can opacify through calcification, with calcium phosphate deposits binding within the hydrogel matrix. Risk factors include vitrectomy with gas or silicone oil tamponade, diabetes, and systemic conditions altering the blood-aqueous barrier. Glistening affects hydrophobic acrylic lenses and consists of water microvacuoles causing glare without opacity, while YAG pits are focal surface marks, not diffuse milky opacification.

Reference: AAO Basic and Clinical Science Course, Lens and Cataract Section 11, 2023-2024 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.