Phakic anterior chamber intraocular lenses in the management of high myopia

The aim of this work was to study the clinical and optical results and safety of anterior chamber phakic intraocular lenses in patients with high myopia. Seventeen eyes of 11 patients with myopia ranging between -10.5 to -24 D were included in the study. Uncorrected visual acuity, best spectacle corrected visual acuity, refraction, spherical equivalent, astigmatism, intraocular pressure, papillary ovalization and central corneal thickness were studied before the operation and after week, one month, six months and one year. Endothelial cell count was done before surgery and one year after surgery. Uncorrected visual acuity, best spectacle corrected visual acuity, refraction and spherical equivalent showed statistically significant improvement, which lasted throughout one-year follow up. Temporary changes in intraocular pressure, central corneal thickness and astigmatism were noted, but were restored later to mean preoperative levels. Endothelial cell count decreased significantly from the preoperative levels, but was not less than 2000/mm2. In one case, the lens had to be explanted due to chronic inflammatory reaction

Behavior of intraocular pressure following different methods of cataract extraction

In this prospective study of 100 eyes of 97 consecutive patients, we attempted to detect differences in the course of intraocular pressure [IOP] after two main types of non-enzymatic cataract extraction: intracapsular extraction without alphachymotrypsin [30 eyes], and planned extracapsular extraction [70 eyes] with insertion of a posterior chamber intraocular lens without sodium hyaluronate [21 eyes]. IOP was measured with a non-contact applanation tonometer preoperatively and at specified intervals up to 3 months after surgery. No significant difference in IOP could be detected according to the types of cataract surgery. Transient ocular hypertension occurring within the first few postoperative days was seen in 59% of all eyes; there was no significant association with any parameter of the surgery. In contrast, a cause could often be found for the ocular hypotension that occurred in 11% of eyes in the first seven postoperative days. Late postoperative hypotension was recorded after the seventh postoperative day in 75% of all cases and persisted for an a verage of 4 weeks, a cause for this was rarely found. In 22% of all cases, IOP remained within normal limits [10 to 20 mmHg] throughout the postoperative period