Wave-like calcification on the posterior surface of an acrylic hydrophilic bag-in-the-lens (BIL) implant

PURPOSE: To report secondary opacification of a hydrophilic bag-in-the-lens (BIL) which is a rare manifestation that can happen years after initial surgery. OBSERVATIONS: We describe a case of a prominent wave-like, rippled opacification on the posterior surface of the BIL. The opacification was composed of calcium deposits and seems to start in the periphery as a ring and progresses to the centre of the posterior surface. Due to the specific design of the BIL, there is direct contact between the BIL and the posterior chamber, both with the space of Berger, and the anterior hyaloid, particularly in this very hyperopic eye. Conclusions and importance: Abnormal fluid flow and stagnation in an unusual retrolenticular space is a possible explanation for this unusual pattern of posterior surface opacification.