Complications and visual outcome of sclerally fixed posterior chamber intraocular lenses

Hundred eyes of 97 patients were operated for determining complications and visual outcome of Sclerally Fixed Posterior Chamber Intraocular Lenses at Institute of Ophthalmology, Mayo Hospital, Lahore from January 2002 till December 2002. Those operated either had ICCE done previously, per-operated large rent in posterior capsules, dislocated lens and t raumatic subluxated cataractous Iens. Immediate complications were transient rise in IOP, corneal edema, striate keratopathy. Late complications noted had decentration of IOL [4%], Cystoid Macular edema 4%, suture erosion [2%] and lens tilt [1%]. 80% patients had Post-operative V/A of 6/6-6/12 and 20% had V/A 6/18- 6/60 as compared to Pre-Operative V/A of 56% in 6/6-6/12, 10% in 6/18-6/60 and 34% in 3/60-PL+ ve. Encouraging results favour this procedure

Efficacy of primary implantation of flexible open loop anterior chamber intra-ocularlenses

Eighteen eyes of sixteen patients [eight males with age ranged from Thirty-two to seventy-two years with mean age of fifty-four years and eight females with age ranged from forty-five to seventy-five years with mean age of fifty-five years] were operated on in the period from November 1993 to June 1997. All eyes were implanted with flexible open loop anterior chamber lenses [AC-IOL]. At the end of the follow up period which ranged from three to twenty-one months with mean of eight months, unaided vision of six eyes was 6/12 or better and was better than 6/36 in fifteen eyes and three eyes had vision of 6/60 or less. The undesirable postoperative findings noted were deposits on intraocular lens [IOL] in three eyes, prolapse of iris round IOL in three eyes, iritis in four eyes, glaucoma in two eyes, vertically oval pupil in four eyes and hyphema in one eye of diabetic patient. In spite of these findings, flexible open-loop anterior chamber lenses are considered visually effective and relatively safe for primary implantation when impossible or inadvisable to place posterior chamber intraocular lenses

Extracapsular cataract extraction with posterior chamber IOL implantation at Helpers eye hospital, Quetta

We have only recently started intraocular lens [IOL] implantation surgery in Quetta, Baluchistan at the Helpers Eye Hospital, and this is the first report of our results of the manual extracapsular cataract extraction with posterior chamber [IOL] implantation. The procedure was performed on 134 patients. An important socioeconomic aspect of cataract surgery in our region was brought home by the fact that 31 of these patients did not return for follow-up. Another three patients died of acute myocardial infarction. In the remaining 100 patients, postoperative visual acuity ranged from 3/60 to 6/6; 79 patients regained unaided visual acuity of 6/24 [20/80], which improved to 6/9 [20/30] or better with correction; 14 patients had vision below 6/36 [20/120], which improved to 6/12 [20/40] with glasses; five patients could improve only to 6/60 [20/200] with best correction; two patients' visual acuity did not improve beyond 3/60 [10/200] due to the advanced macular degeneration. The postoperative complications include posterior capsule thickening in eight patients [8%]; anterior uveitis in seven patient [7%]; vascular congestion at and around the wound persisting after one month in 20 patients [20%]; traumatic wound dehiscence in three patients [3%]; IOL decentration in two patients [2%]; elevated intraocular pressure in two patients [2%]; traumatic vitreous hemorrhage in one patient [1%]; distortion of pupil in one patient [1%]; and endophthalmitis in one patient [1%]. [Pakistan Journal of Ophthalmology, 10:49-50, April and July, 1994]

Trabeculectomy combined with transscleral sutured posterior chamber lens in the management of glaucoma in aphakia

Twenty-nine unilaterally aphakic patients with uncontrolled glaucoma underwent combined trabeculectomy, vitrectomy and transscleral sutured posterior chamber intraocular lens implantation. Postoperatively, all patients received a total of 50 mg 5-fluorouracil by subconjunctival injections. The mean age was 50.6 years with mean follow-up time of 12 months. The mean preoperative intraocular pressure [IOP] was 30.3 mm Hg [SD=6.6] with postoperative mean reduction of 12 +/- 4.1 mm Hg [p <0.005]. Mean preoperative corrected visual acuity was 20/50 [range 20/30-20/100] and mean postoperative corrected visual acuity was 20/70 [range 20/30-20/200]

Primary in tcaocular lens implantation visual results

Visual acuity results at one year follow-up in 195 patients with primary in traocular lens implantation [lOLl] are presented. From 186 eyes with extracapsular cataract extraction and posterior chamber lOLl, 94.62% have visual acuity of 20/40 or more. Eyes with posterior chamber IOL have better visual acuity [94.62%] than anterior chamber IOL [88.88%]. Elderly patients have a 92.5% chance of visual recovery due to macular degeneration. Poor prognosis for improved visual acuity [88.6%] in young patients is mainly due to posterior capsular opacity, which is curable

Corneal endothelial cell losses after posterior chamber intra-ocular lens implantation

In order to find out the effect of posterior IOL on the corneal endothelial count, a group of 28 patients under going Ex.C.C.Ex with posterior IOL under went specular microscopic endothelial cells photographs before surgery, 1 month, 6 months and 12 months after surgery. 10 cases of Ex.C.C.Ex without implantation of lenes served as control. After 1 month, I found no significant difference in the endothelial cell losses in both groups. 6 months and 1 year postoperatively photographs showed significant endothelial cell loss in cases with posterior IOL

Propionibacterium acne endophthalmitis after ECCE and IOL implantation: a case report

We report a case of post-extracapsular cataract extraction [ECCE] infection with Propionibacterium acnes. The diagnosis was preceeded by almost two years persistent, smoldering inflammation and only confirmed by culture when the lens was removed on the suspicion of the so called toxic lens syndrome

Extracapsular cataract extraction with posterior chamber intraocular lens implantation at the Rawalpindi general hospital

Out of a total of 220 consecutive patients who underwent extracapsular cataract extraction with posterior chamber intraocular lens implantation at the Rawalpindi General Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan, 135 [61.4%] patients did not keep their appointments for follow-up. This discouraging pattern is universal in Pakistan and makes clinical studies very difficult and less than ideal for drawing reliable conclusions. The following postoperative complications appeared in the 85 patients who did come for follow-up visits: anterior uveitis in 17 [20%] patients, after cataract [secondary cataract] in 11 [13.5%], glaucoma in 3 [3.5%], lens implant decentration in 3 [3.5%], and cystoid macular edema in 3 [3.5%]. Intraopera-tively, posterior capsular rupture with or without vitreous loss occurred in three [3.5%] patients and the removal of anterior capsule was not complete in another three [3.5%]. One female diabetic patient totally lost her sight due to postoperative rubeosis iridis and hyphema causing severe thrombotic [neovascular] glaucoma. One man [1.17%] developed bacterial endophthalmitis. The infection was successfully controlled, but the eye developed total corneal decompensation. A partially successful penetrating keratoplasty gave this patient a visual acuity of counting fingers. Of the 11 after cataract [posterior capsule opacification] cases, eight were treated with neodymium: YAG laser capsulotomy and three with surgical capsulotomy. Out of a total of 14 eyes which had traumatic cataract, 11 recovered a visual acuity of 6/36 [20/120] or better, two a visual acuity of 6/60 [20/200], and one only light perception

Macular holes following lens implantation surgery

Two patients, women of 56 and 62, developed macular hole soon after extracapsular cataract extraction with posterior chamber intraocular lens implantation. Although preoperative macular function test [MFT] gave visual acuity of 20/40 [6/12] in each patient, the best visual acuity achieved postoperatively was 20/200 [6/60] in the first patient and 20/100 [6/30] in the second. It is important that the eye surgeons remain alert to this relatively uncommon but very distressing postoperative complication while planning for and during the intraocular manipulations of cataract operation