Morphological changes and lens position 2½ years after intracapsular cataract extraction with implantation of a semiflexible anterior chamber lens

Abstract

Morphological changes and lens position were examined in 51 patients 25 to 38 (mean 30) months after intracapsular cataract extraction (ICCE) with implantation of the semiflexible, 3M, style 70, anterior chamber lens. Morphological changes presumably associated with the ICCE proper were: iris transillumination defects (68.6%), rupture of anterior hyaloid membrane (20%), detachment of posterior vitreous (42.9%) and anterior synecchiae (13.7%). The implant-related morphological changes were caused by iris tucking (19.6%), small, mobile lenses causing endothelial disturbance (9.8%), iris-haptic adhesions and progressive ovalling of pupillary form. The present morphological changes were compared with a previously published examination of the same patients performed 4 months after surgery: 9 eyes without tissue changes around the lens feet at the previous follow-up now had iris-haptic adhesions involving from 1 to 4 lens feet. In 8 eyes the iris-haptic adhesions had progressed. Compared with the previous examination the fraction of eyes with tissue changes at the lens feet had risen from 47.1 to 64.7%, while the number of eyes with oval pupils had increased from 54.9 to 80.4%. Contact between lens haptic and iris root seems to constitute a constant stimulus for structural changes of the iris.

Morphological changes 2 1/2 years after extracapsular cataract extraction with implantation of a posterior chamber lens

“…Since this study we have consistently attempted to implant the lenses with both haptics in the capsular bag, which may cause less iris contact (Apple et al 1985). It should be emphasized, that implantation of anterior chamber lenses cause similar progressive reactive changes around the tips of the lens haptics in the chamber angle (Naeser et al 1987).…”

“…We conclude that the posterior lens capsule has reached its permanent position by the fourth postoperative month and that the position of a PCL is extremely constant. In contrast, anterior chamber lenses show great variations in post-operative position (Naeser et al 1987). The constant anterior chamber depth implicates an unchanged spherical equivalent refraction beyond the fourth post-operative month.…”

Evaluation of a flexible one‐piece open‐loop anterior chamber lens ‘Symflex 350B’ 3–4 years after implantation

“…Ovalling is reported more frequently in cases of semiflexible closed-loop ACLs by Naeser et al (1987) and Story (1987) and in cases with a flexible Simcoe ACL by Laage (1984).…”

“…One of our patients developed secondary glaucoma (1.11%). Naeser et al (1987) describes 11.6% secondary glaucomas in ICCE with closed-loop ACL and Kooner et al (1988) found 25.8% secondary glaucomas, of which 11.3% needed long-term medical treatment. Ekdawy (1987) reported glaucoma in 8.7%.…”

“…Our gonioscopic study showed that nearly all the haptics rested on the ciliary body band, and as reported by Reidy et al (1985) most haptics of ACLs do. Malposition of the haptic feet in the chamber angle and tissue around the feet were more often seen in closed-loop ACLs by Ekdawy (1987) and Naeser et al (1987). Skorpik et al (1985), in a gonioscopic study of the Shepard ACL, often found structural changes in the anterior chamber angle.…”