[Clinical results of the aphakia correction by means of secondary implantation of the iris-fixated anterior chamber intraocular lens]

Abstract

The authors refer about the results of the secondary implantation of the anterior chamber intraocular lens (AC IOL) Artisan Aphakia. Those specially constructed iris claw lenses for aphakia correction, fixated on the iris, were implanted at the Department of Ophthalmology in Hradec Králové (Königgrätz, Czech Republic) during the period August 2002-May 2005 in 51 cases (51 eyes, 48 patients). The most common indication (33 % of cases) was the previous trauma with lens damage and consequent postoperative aphakia. The second most common cause (in 29 %) of AC IOL use was the absence of the lens after the posterior segment surgery due to the retinal detachment. In 18 % of cases the aphakia was as a result of the complicated intracapsular or extracapsular cataract extraction. The other indications (20 %) for the AC IOL implantation are patients with subluxated their own (natural) lens in Marfan's syndrome; after posterior segment surgery due to the intravitreal hemorrhage with primary cataract extraction without the IOL implantation; and after the luxation of the artificial intraocular lens or the lens remnants as a primary complication after the cataract surgery. The average patients' age at the time of surgery was 59 years (range, 8-86 years). Men participated in 70.6 % of cases. In the group of patients, there was one child as well. Before the surgery, the average spherical refractive error was +9.8 +/- 2.2 diopters (D) (range, 3-15 D), the average uncorrected visual acuity was 0.05 +/- 0.09; the best-corrected visual acuity was 0.42 +/- 0.29. No complication during the surgeries was noticed. The followed parameters were visual acuity, refraction, AC IOL position, and occurrence of complications. The average follow-up period was 13.0 months (range, 2-30 months). After the surgery, the average spherical refraction decreased to -0.5 +/- 1.62 D. The uncorrected visual acuity was 0.27 +/- 0.23 and the best-corrected visual acuity was 0.43 +/- 0.28. As complications, we noticed the secondary glaucoma in three cases, in two cases bleeding into the anterior chamber, in 5 cases iritis, and in one case the subluxation of the artificial lens.