Impact of calcium and phosphorus levels on optical deterioration in primary and secondary intraocular lens calcification

The purpose of this study was to investigate the impact of calcium and phosphorus levels on optical deterioration in primary and secondary intraocular lens (IOL) calcification. A total of 18 explanted IOLs, 10 with primary, and 8 with secondary calcification, were examined. Straylight and light l...

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Main Authors: Britz, Leoni (Author) , Hammer, Maximilian (Author) , Łabuz, Grzegorz (Author) , Zielinska, Agnieszka (Author) , Jester, Fabian (Author) , Freudenberg, Jan (Author) , Bunz, Uwe H. F. (Author) , Scholz, Christian (Author) , Auffarth, Gerd U. (Author) , Yildirim, Timur Mert (Author)
Format: Article (Journal)
Language:English
Published: October 2024
In: Translational Vision Science & Technology
Year: 2024, Volume: 13, Issue: 10, Pages: 1-10
ISSN:2164-2591
DOI:10.1167/tvst.13.10.18
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1167/tvst.13.10.18
Verlag, kostenfrei, Volltext: https://tvst.arvojournals.org/article.aspx?articleid=2802118
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Author Notes:Leoni Britz, Maximilian Hammer, Grzegorz Łabuz, Agnieszka Zielinska, Fabian Jester, Jan Freudenberg, Uwe Bunz, Christian Scholz, Gerd Uwe Auffarth, and Timur Mert Yildirim

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520 |a The purpose of this study was to investigate the impact of calcium and phosphorus levels on optical deterioration in primary and secondary intraocular lens (IOL) calcification. A total of 18 explanted IOLs, 10 with primary, and 8 with secondary calcification, were examined. Straylight and light loss were evaluated as predictors of optical impairment. The individual amount of calcium and phosphorus was determined using thermogravimetry followed by emission spectroscopy (ICP-OES). The relationship between calcification and optical impairment was investigated. Primary calcified IOLs contained significantly higher amounts of calcium and phosphorus compared to secondary calcified IOLs (calcium P < 0.02 and phosphorus P < 0.01), translating to greater light loss and significantly higher straylight mean values. In secondary calcification, light loss and straylight were highly dependent on calcium (r² = 0.90, P < 0.001 and r² = 0.70, P < 0.01) and phosphorus (r² = 0.66 and r² = 0.65, both P < 0.02), whereas these correlations were much lower in primary calcification (all r = 0.25, P > 0.05). ICP-OES is the first methodology to precisely assess the calcium and phosphorus content in IOL calcification thus based on mass ratios allowing improved molecular characterization. Primary calcification showed higher amounts of calcium and phosphorus, translating to higher straylight and light loss and thus a higher risk for impairment of visual quality than secondary calcification. This study is the first to quantify calcification and demonstrate the relationship to optical deterioration in IOLs, substantially contributing to understand how visual impairment arises in patients with calcified IOLs. 
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