The long term clinical outcome of anterior chamber lenses after cataract surgery

Purpose:
To analyse the functional results and postoperative complications of primary and secondary anterior chamber lenses implantation in a follow up of 10 years.

Patients and method:
Sixty one patients (64 eyes), 29 females and 32 males, between 22 and 96 year of age (midding 64 years), who underwent cataract surgery with anterior lens implantation from 1990 to 2000 were analysed. It was performed with cataract removal in 51 eyes (after intracapsular extraction in 18 eyes and 33 eyes with intraoperative complications making impossible to apply the posterior chamber intraocular lens). The secondary implantation was complied in 13 aphakic eyes from 1 to 13 years after cataract removal. Thirty nine patients were subjected to the control examination on October of 2000 year. The visual acuity, intraocular pressure, anterior and posterior part of the eye were examined.

Results:
The satisfactory visual function and intraocular pressure were confirmed in most of the patients. The reasons of lower visual acuity were: the retinal detachment (2 eyes), bullous keratopathy (2eyes after vitreous loss), age related macular degeneration (1eye), proliferative diabetic retinopathy (2 eyes). In the anterior part of the eye in 21 eyes (54%) we observed deformation of the pupil's shape, only.

Conclusions:
The anterior chamber lens implantation is an efficacious method of aphakia treatment in some patients.The older patients demonstrated good functional results and tolerance of anterior chamber lens, especially after the cataract removal by krioextraction. The good tolerance and visual acuity were observed either in cases of primary or secondary implantation. In the case of capsular rupture and vitreous loss before AC IOL implantation, a complete (full) vitrectomy should be performed.