Calcification of an intraocular lens designed for sutureless scleral fixation in a patient with band keratopathy

Abstract

Introduction: A case of a calcified Carlevale intraocular lens (IOL), which was explanted or exchanged and underwent laboratory analyses, is reported. Patient and Clinical Findings: A 74-year-old pseudophakic man with a history of type 2 diabetes presented with progressive vision changes 2 years after undergoing vitrectomy and implantation of a Carlevale IOL in the right eye due to previous subluxation of a 3-piece lens. Slitlamp examination was significant for mild band keratopathy and a diffusely opacified Carlevale IOL. Diagnosis, Intervention, and Outcomes: The opacified IOL was explanted and exchanged for an Artisan IOL, with posterior enclavation. Grossly, the explanted IOL exhibited extensive and diffuse deposits/crusts throughout its surface, causing opacification. Scanning electron microscopy coupled with surface analysis confirmed that the deposits/crusts were composed of calcium/phosphate. Conclusions: To the authors' knowledge, this is the first reported case of an opacified Carlevale IOL that underwent laboratory analysis confirming calcification. Alteration in calcium homeostasis that may accompany the diabetic state may represent a contributing factor to the band keratopathy and IOL calcification in this case.