All that Glitters is Not Gold – Diagnosis and Misdiagnosis of Intraocular Lens Opacification

Intraocular lens opacification (IOL) is an uncommon but known entity. As the opacification involves the substance of the IOL and not the posterior capsule, as seen in posterior capsular opacification, neodymium:yttrium–aluminum–garnet (Nd:YAG) laser treatment is ineffective. Furthermore, an attempt at a Nd:YAG laser treatment in a misdiagnosed opacified IOL, compromises the posterior capsule and jeopardizes IOL exchange, the only known treatment so far. The most commonly described cause of IOL opacification is surgical techniques involving air or gas injection. We describe three cases of IOL opacification without any history of a surgical procedure involving air or gas injection.