Full Characterization of Opacifications of a Specific Type of Hydrophilic Intraocular Lenses Including Optical Coherence Tomography Analysis

Purpose: To characterize clinically and morphologically the opacification of a specific type of intraocular lenses (IOLs) Setting: Miranza IOA, Madrid, Spain Design: Ambispective observational study Methods: Fifty-nine eyes of 50 patients who underwent cataract surgery between 2010 and 2017 with implantation of various Lentis Mplus IOL models (Oculentis GmbH, Berlin, Germany) developed IOL opacification. The opacification was assessed via slit lamp examination and optical coherence tomography (OCT). Its impact on visual acuity (VA), far contrast sensitivity (CS) and near vision satisfaction using the NAVQ10 questionnaire. Results: The mean time to IOL opacification development was 56.4±24.0 months. The most common opacification patterns were total diffuse (44.1%), peripheral plaque (33.9%) and miscellaneous (8.5%). Both uncorrected and corrected distance and near VA significantly worsened upon detection of IOL opacification (p<0.001). Mean CS values for 6, 12 and 18 cycles/º fell outside the range of normality. Fewer than 8% of patients reported extreme difficulties performing near vision tasks. OCT measurements revealed mean maximum and minimum opacification thicknesses of 72.2±24.6 and 51.8±21.2 µm, respectively. IOL explantation was required in 8 eyes (13.6%), with significant VA improvement after IOL exchange (p<0.001). Severe postoperative complications occurred in 3 patients following explantation. Conclusions: Opacification of Lentis Mplus IOLs typically presents with a diffuse pattern, leading to deterioration in VA and CS. This complication can be managed by exchanging the opacified IOL with a fully transparent alternative; however, the surgical procedure carries inherent risks that require careful consideration.