Zeitschrift für klinische und experimentelle Ophthalmologie
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A Late Complication of Polymethyl Methacrylate(PMMA) Intraocular Lens- an Unusual Degeneration

LZ Heng, I Fearnley, Ramin Khoramnia, Tamer Tandogan, Chul Young Choi, Gerd U Auffarth and MP Snead

Polymethyl methacrylate (PMMA) was the material used in Sir Harold Ridley’s original intraocular lens (IOL). Until the last decade, PMMA has enjoyed a reputation as a reliable and high quality optical material with very few complications associated with PMMA material alterations having been reported. Here, we report a clinical case of a 72 year old gentleman who presented with progressively increasing glare and decreased vision 20 years after his routine PMMA IOL implantation. The lens was explanted and sent for pathological analysis which revealed greybrown ‘bubble-like’ lesions which were empty. Scanning electron microscopy showed cracks in the PMMA material which were correlated to decreased optical quality. The current findings are dissimilar from the known phenomenon of ‘snow flake degeneration’, which was the only reported late complication of PMMA lenses. This case report describes a new variant of an unexpected late complication associated with PMMA lenses.