The physical nature of an IOL depends mainly on the material it is made up of. Although surface changes on the lens capsule can manifest as capsular opacification, as often noted after cataract surgery, IOL surface changes are not common. Optic abrasions, pigment dispersion, discoloration and opacification are the possible surface changes that can happen in the optic. An optic of 3 mm to 4 mm covers the pupillary zone in a normal anatomical situation, and surface abnormalities in this zone risk disturbing the patient’s best corrected vision. Optic opacification has been reported in various lens materials, including silicone and hydrophilic acrylic. In this column, we will highlight some of our interesting cases of IOL surface abnormalities, discoloration and opacification, and their method of management in concomitant ocular comorbidity.Water vapor can be absorbed into IOL material, especially hydrogel, causing discoloration of the optic. Small fluid-filled vacuoles within the optic of the IOL may be due to a change in the immediate micro-environmental temperature. Calcium deposition and subsequent opacification have been shown in hydrophilic lenses. Silicone oil-filled eyes undergoing cataract surgery with IOL implantation run the risk of adhesion of silicone oil to the IOL surface, especially to silicone optic IOL designs. Interface or interlenticular opacification can happen in piggyback lenses.
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