Long term clinical outcome of a randomised controlled trial of anterior chamber lenses after high volume intracapsular cataract surgery

Abstract

Background-Age related cataract remains the major cause of blindness throughout the world. In many countries, the majority of cataract surgery continues to be done by the intracapsular cataract extraction (ICCE) method. The results of a large randomised controlled trial of multiflex open loop anterior chamber intraocular lenses (ACIOL) were reported from a busy eye hospital in Nepal. Methods-There was a randomised controlled trial of 2000 people with bilateral cataract reducing vision to less than 6/36. Interventions were ICCE with an ACIOL compared with ICCE with aphakic spectacles (+11 dioptres). Participants were followed at discharge, 6 weeks, 1 year, and 1 1 ⁄2-5 years after surgery. Visual acuity and clinical outcome were measured. A poor outcome was defined as vision <6/60. Results-Visual outcome was comparable in the two groups. More of the control group experienced functional blindness due to loss of aphakic spectacles at 1 year. The majority of cases of poor outcome occurred in the first year after surgery. There was no indication of any lens related problems after 1 year.Conclusion-Multiflex open loop anterior chamber lenses are safe for up to 1 year of follow up when used by experienced surgeons, and the available evidence of 2-5 years of follow up suggests that the complication rate is reasonably low. An ACIOL at the time of cataract surgery oVers benefits over routine ICCE surgery with aphakic spectacle correction as it avoids the problem of replacing lost and broken spectacles. (Br J Ophthalmol 2001;85:11-17) Age related cataract remains by far the single major cause of blindness throughout the world.

Visual outcomes following Artisan aphakia iris claw lens implantation

“…13 Yang et al 14 reported a series of 65 eyes in 61 patients who underwent SPCIOL placement, with 66% of the patients achieving improved or unchanged BCVA at the final follow-up. In total, 37% of patients experienced preor post-operative adverse events.…”

Ursache von Austausch und Explantation von Intraokularlinsen

“…Hauptgründe für die Explantation von VKL sind sowohl in der Literatur als auch in unserer Serie nach wie vor Hornhautdekompensation und chronischer Reizzustand [11 -13]. Die vergleichsweise eher niedrige Rate an VKL-assoziierten Komplikationen könnte -neben der insgesamt viel geringeren Anzahl implantierter VKL gegenüber HKL -in unserer Serie daran liegen, dass die Ergebnisse von VKL insgesamt besser sind als früher angenommen [6,20]. Zusammenfassend spiegelt die vorgestellte Serie wider, dass die Probleme, welche zu einer Explantation von IOL führen, sich vergleichbar auf die einzelnen Ursachen verteilen, wie in anderen Serien berichtet.…”

Scleral Fixated Posterior Chamber Intraocular Lens for Children with Traumatic Cataract

“…However, anterior chamber lens implantation may result in severe endothelial cell loss followed by corneal decompensation, uveitis, cystoid edema, distorted pupil, and secondary glaucoma or pupillary block. 9,10 Although bullous keratopathy and iridocorneal angle damage are less frequent with new generation anterior chamber IOLs, these complications limit the use of these IOLs in pediatric age with long time expectancy especially because of the possible hazardous effects on central endothelial cell density. 7,11 Posterior chamber IOL implantation causes less damage to cornea, iris and iridocorneal angle structures theoretically.…”