REDUCED VISION SECONDARY TO PIGMENTED CELLULAR MEMBRANES ON SILICONE INTRAOCULAR LENSES

PURPOSE: Visually significant, pigmented cellular membranes may form o n intraocular lenses after implantation. We studied a series of patien ts to determine the onset, visual significance, treatment, and recurre nt nature of these pigmented membranes in patients who underwent surge ry with silicone lens implantation. METHODS: In nine eyes (eight patie nts) with visually significant pigmented cellular membranes on their A llergan Medical Optics (Irvine, California) silicone intraocular lense s (model SI18NGB or SI26NB), eight underwent combined phacoemulsificat ion, intraocular lens implantation, and trabeculectomy; one underwent phacoemulsification and lens implantation only. We reviewed medical re cords to identify preoperative, operative, and postoperative similarit ies and differences in care. Clinical examinations and slit-lamp photo graphs, over an average of 21.3 +/- 7.2 months (range, 11 to 31 months ), documented the effects of different treatment modalities. RESULTS: The patients sought treatment ten to 20 weeks (mean, 15 weeks) postope ratively. Except for the cellular membranes, each eye was without evid ence of inflammation or cystoid macular edema. Subjective complaints d ecreased, and best-corrected Snellen visual acuity improved with topic al corticosteroid therapy alone. Pretreatment best-corrected visual ac uities ranged from 20/40 to 20/400 (mean, 20/70 using Snellen fraction s) and improved two to eight (mean, five) Snellen lines, to a range of 20/20 to 20/50 (mean, 20/25). All nine eyes had recurrence of the mem branes after treatment terminated and required a maintenance regimen o f corticosteroid eyedrops. CONCLUSION: The pigmented cellular membrane s observed on these silicone lenses were visually significant to each patient. The membranes resolved and visual acuity improved with topica l corticosteroid treatment alone but recurred in all patients on cessa tion of treatment.