PURPOSE: To report the ultrastructural and elemental features of two opacified intraocular lenses (IOLs). DESIGN: Histopathologic case series. METHODS: Two opaque hydrophilic acrylic IOLs (Hydroview H60M, Bausch & Lomb Surgical Clearwater, Florida, USA) explanted from two Chinese patients in Taiwan. The explanted IOLs were evaluated by light microscopy, scanning electron microscopy, and energy-dispersive x-ray spectroscopy. RESULTS: Brownish granular and scattered crystal-like deposits were found in case 2, whereas only fine white granular deposits were found in case 1. Using EDX spectroscopy, the elements of deposits on IOL optics were calcium and phosphorus in case 1, but in case 2, fluorine, magnesium, and sodium were demonstrated in addition to calcium and phosphorus. CONCLUSIONS: Our study indicated a difference in morphology and elements of deposits on opaque IOL optics between these two cases. It was suggested that multiple elements may contribute to the formation of deposits.
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