The relation of the location of haptics of posterior chamber intraocular lenses and peripheral anterior synechia

Abstract

Purpose: To investigate the occurrence, outcome and influencial factors of the peripheral anterior synechia (PAS) following implantation of posterior chamber intraocular lenses for finding a way to reduce the PAS.

Subjects: 40 eyes of 38 senile cataract patients with normal chamber angle and intraocular pressure (IOP) preoperatively were examined.

Methods: Extracapsular cataract extraction was performed under microscope with insertion of a posterior chamber lens implant vaulted anteriorly by 10 degrees. Gonioscopy and slit-lamp examination and photography of the operated eyes were performed 3 to 6 months postoperatively.

Results: PAS were found in 20 (50%) of the 40 eyes. Among the 20 eyes with PAS the locations of 23 haptics in 17 eyes corresponded with those of the PAS. PAS were seen more frequently with vertically sulcus-fixated haptics than with the horizontally capsular-fixated haptics, showing a significant difference (P < 0.05). 88% of the eyes with PAS had pupillary deformation, but their visual acuities and IOP were not affected.

Conclusions: PAS is more likely to occur with vertically sulcus-fixated IOL. Rotating the capsular-fixated haptics to the horizontal position may reduce the incidence of PAS. Gonioscopy should be a routine follow-up examination.