A Histomorphological Study on the Effect of Iridocapsular Intraocular Lens on the Iris

Abstract

A Binkhorst iridocapsular intraocular lens was implanted into an eye of a patient after an extracapsular cataract extraction. The patient died 4 months after surgery of gastric cancer. The eye was obtained for histopathologic examination at the autopsy. The superior loop was inside the residual capsular bag causing no damage to the iris and ciliary body. The inferior loop, however, was found outside the capsular sac and caused depression of the iris tissue but neither inflammation nor scamng of the iris had developed. These findings emphasize the importance of the location of iridocapsular intraocular lenses which can cause mechanical damage to the supporting tissues if the loops are not placed inside the capsular bag.

Long-term pathological follow-up of 2-loop iridocapsular intraocular lens

“…However, some studies note that if one or both loops were placed outside the capsular bag, it would essentially convert the iridocapsular IOL to an iris-supported IOL, eventually leading to pathology of the iris and supporting tissues. 8,10 On gross and microscopic analyses, our specimen showed interruption of the iris pigment epithelium, primarily in areas where the loops were in direct contact with the posterior iris surface, outside the capsular bag remnants. This was similar to the findings of Veress and Barkman 8 in their analyses of a cadaver eye implanted with an iridocapsular IOL obtained 4 months after surgery.…”

“…The overall design of this type of IOL would provide better stability within the eye. [6][7][8][9][10] showed that compared with iris-clip IOLs, iridocapsular IOLs had a markedly decreased rate of corneal bullous keratopathy. However, some studies note that if one or both loops were placed outside the capsular bag, it would essentially convert the iridocapsular IOL to an iris-supported IOL, eventually leading to pathology of the iris and supporting tissues.…”

“…The optical component of this IOL remained in front of the iris, but the haptics were inserted into the residual capsular bag after extracapsular extraction or placed in the iridocapsular cleft, where iridocapsular adhesions were expected to embed them, providing stability. [6][7][8][9][10] We recently had the opportunity to perform pathological analyses of an enucleated eye, obtained postmortem, that had a 2-loop iridocapsular IOL. To our knowledge, this is the longest reported follow-up describing the long-term pathological results of this type of IOL in the human eye.…”

Successful Intraocular Lens Implantation: A Histological and Scanning Electron Microscopic Study of Four Cases

“…The importance of the loops of iridocapsular lenses being held in resudual lens capsule has been emphasized by Veress and Barkman (1982) and Manschot (1978) considered that the production of mpseudoconnective tissuer played an important role in anchoring such lenses. However, in Case 2. the lens had remained in position with little evidence of such tissue being observed.…”