Nine hundred and thirty‐eight consecutive primary intraocular lens (IOL) implant cases performed at The Wilmer Institute during the past six years by two surgeons were reviewed. Progressive corneal endothelial cell loss and an increased rate of late‐onset corneal oedema were detected in the group with the Morcher (European) four‐loop iris‐clip Binkhorst IOLs. A higher rate of clinically‐significant cystoid macular oedema developed in eyes with the American‐manufactured four‐loop Binkhorst lens, presumably from chronic iritis caused by contaminants on the IOLs. Our short‐term results with the American‐manufactured Shearing‐type IOLs implanted at the time of extracapsular cataract extraction are encouraging, with 96% of cases achieving 20/40 vision or better, excluding those with known macular degeneration or amblyopia.
Analysis of data submitted to the United States Food and Drug Administration (FDA) indicates, that most of the four classes of intraocular lenses (anterior chamber, pupillary‐supported, iridocapsular. and posterior chamber) are safe and effective at one‐year follow‐up. During the past three years there has been a gradual shift of preference in the type of IOLs being implanted—away from pupillary‐supported and iridocapsular IOLs and, in part, from anterior chamber IOLs, to posterior chamber IOLs. A continued conservative approach to IOL implantation is recommended.
We treated an opacified membrane on the anterior surfaces of the posterior capsule of two cynomologous monkeys that had undergone extracapsular cataract extraction and intraocular lens insertion. After development of opacification of the posterior capsule, argon laser energy was employed in an attempt to debride the capsules while maintaining structural integrity of the capsule. With this technique, small areas of destruction of the membrane on the anterior surface of the posterior capsule were created with preservation of the capsule.
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