Primary or secondary anterior chamber lens implantation after extracapsular cataract surgery and vitreous loss

Abstract

SummaryWhilst an anterior chamber lens implant (AC IOL) can be implanted during extra capsular cataract extraction with vitreous loss managed by anterior vitrectomy, lens implantation as a secondary procedure may avoid complications. We reviewed 47 consecutive cases of vitreous loss, 37 managed with primary and 10 with secondary AC IOLs. There was no significant difference in the level of final visual acuity but, as expected, it was reached earlier in the primary group (p<O.OOI). In the secondary group post-operative astigmatism was less marked (p<0.05) and the AC IOL haptic feet were correctly sited in the angle more frequently (p<0.05). Primary implant patients experienced more recurrent attacks of anterior uveitis (p<O.OI) although the incidence of cystoid macular oedema and retinal detachment did not differ sig nificantly. The results suggest that correct AC IOL positioning is more likely with a secondary procedure and that post-operative complications are fewer.

Visual outcome and complications after posterior iris-claw aphakic intraocular lens implantation

“…This is comparable to the results in previous studies of PC iris-claw IOLs, 21 anterior-fixated iris-claw IOLs, 22,23 secondary open-loop AC IOLs (60% to 77% of eyes 11,24 ), secondary sulcus-sutured PC IOLs (53.8% to 77.8% 3,14 ), and secondary iris-sutured PC IOLs (60% to 67% 8,25 ).…”

Iris-claw intraocular lenses to correct aphakia in the absence of capsule support

“…This is comparable to results in a previous study of iris-claw IOLs 4 and in studies using secondary open-loop AC IOLs (60% to 77% eyes with a CDVA of 20/40 or better 11,12 ), secondary sulcussutured PC IOLs (53.8% to 77.8% 13,14 ), or secondary iris-sutured PC IOLs (60% to 67% 15,16 ). However, when reviewing the literature, it is often difficult to accurately assess the visual outcomes with each of these IOL types because the eyes in which they are implanted often had complicated cataract surgery, which may itself limit final visual acuity or cause complications.…”

“…A common concern with the use of angle-supported AC IOLs is the development of PBK (incidence reported from 0% to 14% 11,18 and from 0% to 18% 20,21 in the presence of PKP). In our series, only 2 eyes (1.7%) developed corneal decompensation over 3-to 79-month follow-up (mean 22.4 months).…”

Long-term evaluation of primary anterior chamber intraocular lens implantation in complicated cataract surgery

“…The visual result was satisfactory; 68% received a visual acuity of 0.5 or better which is compatible with previously published figures [14]. In one eye visual impairment was related to cystoid macular oedema, but even this may be regarded secondary to intra-or postoperative complications rather than to the presence of an AC IOL [8].…”