The Correction of Aphakia Using Anterior Chamber Intraocular Lens

Abstract

Abstract. Senile The crystalline lens is a transparent biconvex structure, participating in the refractive system of the eye. Any metabolic disturbance in the lens result in localized or diffuse opacification, called a cataract (1). Senile cataract is the leading cause of severe vision loss and blindness worldwide, affecting approximately 20 million people (2-6). The visual rehabilitation required after cataract surgery is usually treated with aphakic glasses, contact lenses, and intraocular lenses (IOLs), which can be placed in the anterior or posterior chamber (7). The use of anterior chamber IOLs (AC IOLs) for the correction of aphakia was first reported in the 1960s (8, 9). However, this method was abandoned for about 20 years due to the high incidence of complications and the progression of cataract surgery (10). In 1996, AC IOLs were implanted in 1.09% of patients who underwent cataract extractions; this percentage had increased to 43% by 2000 (11). Since the development of AC IOLs, their design has been frequently modified, ultimately changing from a biconcave form to a convex-concave one (12, 13). The latter is designed to protect the corneal endothelium, which is usually vulnerable to lensinduced damage. The indications for the use of AC IOLs include extracapsular cataract extraction with intraoperative complications, intracapsular cataract extraction, secondary implantation and penetrating keratoplasty (11).To our knowledge, this is the first article focusing on aphakic AC IOLs, and reviewing their visual outcome and complications. Outcomes and Complications Following Implantation of AC IOLs in Aphakia

Five-year follow-up of secondary iris-claw intraocular lens implantation for the treatment of aphakia: Anterior chamber versus retropupillary implantation

“…Several complications have been reported about each of these secondary implants in previous studies. The most common complication of angle-supported anterior chamber IOLs was bullous keratopathy, followed by lens dislocation, secondary glaucoma, macular edema and retinal detachment [5]. Scleral-sutured IOLs offer the advantage of fixation in the posterior chamber, but the surgical technique is technically more difficult and requires a longer surgical time.…”

Anterior Versus Retropupillary Iris-Claw Intraocular Lens: Indications, Visual Outcome and Postoperative Complications

“…Regarding anterior chamber IOL, surgical implantation is safe and fast. On the other hand, use of these IOLs is well known to cause secondary glaucoma, endothelial cell loss, bullous keratopathy, and uveitis [6]. Scleral-fixated IOLs have advantages over anterior chamber IOL in that they are far away from the angle, and they respect the anatomy of the eye despite the difficulty and long operation procedure with extensive intraocular manipulation.…”

Outcome of four-point fixated open loop polymethyl methacrylate anterior chamber intraocular lens

“…ACIOL insertion is a relatively simple procedure and can be planned along with cataract extraction. However, the main concerns are the potential side effects such as corneal decompensation, raised intraocular pressure (IOP) and cystoid macular edema [2]. ACIOLs have regained popularity as the openloop haptic design used currently has a better safety profile than the closed-loop design [3,4].…”