Acrylic intraocular lenses in patients with patch test-confirmed acrylate allergy: two cases with 1-year follow-up

Purpose To report our experience with two cases of acrylate allergy confirmed by patch testing, wherein acrylic intraocular lens (IOL) implantation was performed and followed up for 1 year. Observations Case 1 A 78-year-old woman with an allergy to acrylic resin consulted a general allergist because of suspected depigmented contact dermatitis. A patch test was positive for methyl methacrylate and 2-hydroxyethyl methacrylate (2-HEMA), which are acrylic resins. Before cataract surgery, patch tests for the IOL and other acrylic resin materials were performed, all of which tested negative. Case 2: A 49-year-old woman was allergic to several substances, including acrylic resin. A patch test was positive for 2-HEMA and ethylene glycol dimethacrylate. We consulted an anesthesiologist regarding immediate-type allergy and explained to the patient about the possibility of IOL removal for delayed-type allergy. Intra-or postoperative complications were not observed in either patient. Postoperative inflammation was similar to that observed after conventional cataract surgeries. During the 1-year follow-up period, worsening of inflammation in the anterior chamber or other symptoms indicative of delayed hypersensitivity were not observed. Conclusions and importance In two patients with cutaneous acrylate allergy, hydrophobic acrylic IOL implantation was uneventful through the 1-year follow-up period. Careful preoperative patch testing, allergist collaboration, informed consent about uncertain long-term risk, and close follow-up are advised.