Outcomes of Corneal Transplant in Childhood Glaucoma.

PRCIS: Childhood glaucoma produces alterations in the postnatal development and function of various ocular structures, including the cornea. Childhood glaucoma patients present lower corneal transplant survival rates. Our series shows outcomes of corneal transplant in childhood glaucoma with survival rates of 29% at 2 years. OBJECTIVE: To investigate the surgical outcome of different types of keratoplasty in eyes with childhood glaucoma. PATIENTS AND METHODS: A retrospective review was made of the medical records from 17 eyes of 15 patients who were diagnosed with childhood glaucoma and received a corneal transplantation between January 2010 and July 2020. Patient demographics, intraocular pressure, previous ocular surgery, comorbidities, corneal transplant surgery, and follow-up outcome were collected. The primary efficacy endpoint was graft survival (in months) until failure, the latter being considered as irreversible loss of corneal transparency. Secondary efficacy points were the need for an increase in topical hypotensive therapy and the need for additional surgery. RESULTS: Seventeen eyes of 15 patients were included, 11 eyes (10 patients) with primary congenital glaucoma and 6 with other types of childhood glaucoma. Corneal transplantation was performed at the mean age of 23.76 ± 14.86 years. At the time of the transplantation, the number of topical medications was 1.35 ± 1.27, intraocular pressure was 15.00 ± 8.34 mm Hg, and patients had received up to 7 glaucoma surgeries. Descemet stripping automated endothelial keratoplasty was performed in 13 eyes (76%) and penetrating keratoplasty in 4 (24%). After surgery, 7 (41%) eyes required increased topical treatment and 2 (12%) glaucoma surgery. Twelve eyes (71%) developed graft failure at 24 months, the mean time of survival being 13.88 ± 8.25 months. CONCLUSIONS: Management of corneal decompensation in childhood glaucoma poses a challenge. In this series of childhood glaucoma with corneal transplantations, the survival rate was 29% at 24 months.

Clinical outcomes of long-term corneas preserved frozen in Eusol-C used in emergency tectonic grafts.

To report the clinical results on the use of corneas frozen in Eusol-C as tectonic corneal grafts.Retrospective review of medical records of patients who received frozen corneas as emergency tectonic grafts from 2013 to 2020. Corneas had been stored in Eusol-C preservation media at - 78 °C for a mean time of 6.9 months. Diagnosis, transplant characteristics, microbial culture results, anatomic integrity, epithelial healing, neovascularization, transparency, infection and need for additional surgeries were registered. Fifty corneas were used in 40 patients (mean age 60.5 years, 20 males) with a median follow-up of 27.3 months after surgery. Need for tectonic graft was due to: perforation secondary to immune diseases (6, 12%), neurotrophic ulcer (11, 22%), trauma (3, 6%), corneal infection (11, 22%), chronic disorders of the ocular surface (9, 18%) and previous corneal graft failure (10, 22%). Mean size of grafts was 5.6 mm and 36 cases (72%) also received an amniotic membrane graft. Thirty-eight corneas achieved epithelization (76%), 25 (50%) were clear and 19 (38%) developed neovascularization. None of the corneas were rejected. Seventeen corneas (34%) failed: 7 (14%) due to reactivation of baseline disease and 10 (20%) due to primary graft failure. Four corneas (8%) had positive microbial cultures suggestive of contamination and 2 (4%) developed a cornea abscess non-related to a positive microbial culture. Long-term preservation of donor corneas in Eusol-C at - 78 °C is a viable technique to meet the needs of emergency grafts with minimal equipment.

Changes in the total corneal refractive power after insertion of intrastromal rings in patients with keratoconus in short, medium and long term / Mudanças no poder refrativo total da córnea após a inserção de anéis intrastromais em pacientes com ceratocone a curto, médio e longo prazo

ABSTRACT Objective To analyze the short, medium and long-term efficacy and stability in 46 eyes with keratoconus, operated with Ferrara intrastromal corneal ring segments. Methods The primary endpoint was the mean keratometry of total corneal refractive power. We also studied the effects of age, degree of keratoconus and clinical phenotype on the results, as well as the following keratometry variations and aberrometry variations: flattest, most curved, mean, maximum, astigmatism, root mean square of primary coma aberration and root mean square of secondary coma aberration. Results The immediate postoperative reduction in mean keratometry of total corneal refractive power was 3.08±1.51 diopters (D) (p<0.001). At 4 years, the mean keratometry of total corneal refractive power increased to 0.57±0.96D (p=0.005). Between 4 and 7 years, there was no change in mean keratometry of total corneal refractive power (p=0.727). The degree of keratoconus was a factor affecting the efficacy of the intrastromal corneal ring segments, achieving a greater effect in those with a greater degree of keratoconus (p=0.012 between groups). The immediate postoperative reduction was 1.77±1.88D for the flattest, 3.91±2.30D for the most curved, 2.76±1.63D for the mean, 4.42±3.26D for the maximum, 2.15±2.68D for astigmatism, 1.03±0.83µm for root mean square of primary coma aberration and root mean square of secondary coma aberration (p<.001 in all cases). At 4 years, most curved increased by 0.42±0.78D (p=0.001), mean increased by 0.54±0.64 (p<0.001) and root mean square of primary coma aberration decreased 0.14±0.27µm (p=0.020). Conclusion Ferrara intrastromal corneal ring segment implantation is an effective and stable long-term treatment for patients with keratoconus. There is, however, partial regression in the medium term.

RESUMO Objetivo Analisar a eficácia e a estabilidade a curto, médio e longo prazo em 46 olhos com ceratocone, operados com segmentos de anel intrastromal corneano de Ferrara. Métodos A meta primária foi a ceratometria média de poder refrativo total da córnea. Também estudamos os efeitos da idade, grau de ceratocone e fenótipo clínico nos resultados, bem como as seguintes variações de ceratometria e variações de aberrometria: mais plana, mais curva, média, máxima, astigmatismo, raiz quadrada média da aberração comática primária e raiz quadrada média da aberração comática secundária. Resultados A redução pós-operatória imediata da ceratometria média do poder refrativo total da córnea foi de 3,08±1,51 dioptrias (D) (p<0,001). Aos 4 anos, a ceratometria média do poder refrativo total da córnea aumentou para 0,57±0,96D (p=0,005). Entre 4 e 7 anos, não houve mudança na ceratometria média da potência refrativa total da córnea (p=0,727). O grau de ceratocone foi um fator que afetou a eficácia dos segmentos do anel intrastromal da córnea, alcançando um efeito maior naqueles com maior grau de ceratocone (p=0,012 entre grupos). A redução pós-operatória imediata foi de 1,77±1,88D para a mais plana, 3,91±2,30D para a mais curva, 2,76±1,63D para a média, 4,42±3,26D para a máxima, 2,15±2,68D para o astigmatismo, 1,03±0,83µm para a raiz quadrada média da aberração comática primária e raiz quadrada média da aberração comática secundária (p<0,001 em todos os casos). Aos 4 anos, a maioria das curvas aumentou 0,42±0,78D (p=0,001), a média aumentou 0,54±0,64 (p<0,001) e a raiz quadrada média da aberração comática primária diminuiu 0,14±0,27µm (p=0,020). Conclusão O implante de anel intrastromal corneano Ferrara é um tratamento eficaz e estável a longo prazo para pacientes com ceratocone. Há, no entanto, uma regressão parcial a médio prazo.

Depth of field and visual performance after implantation of a new hydrophobic trifocal intraocular lens.

PURPOSE: To assess the depth of field (DOF) by means of defocus curve analysis applying different visual acuity criteria in patients following cataract surgery and bilateral implantation of a new trifocal diffractive intraocular lens (IOL). METHODS: Fifty eyes of 25 consecutive patients who underwent implantation of the Asqelio™ trifocal IOL (AST Products Inc., USA) were enrolled in this observational prospective study. Monocular subjective DOF was obtained from defocus curves with absolute and relative criteria of tolerance for different visual acuities values. Patient's visual satisfaction, postoperative refraction and visual acuity at far, intermediate (67 cm) and near (40 cm) distances were also measured at 1 and 3-months post-surgery. Analysis of variance was used to assess differences in refractive error after the surgical procedure, and paired t-tests were used to assess differences in VA. Patient satisfaction results were reported as percentages. RESULTS: Spherical equivalent was 0.05 ± 0.23 D and residual cylinder 0.01 ± 0.23 D 3-months after the surgery. Absolute DOF obtained was 3.29 ± 0.91 D considering 0.1 LogMAR as cut-off value, and 4.82 ± 0.69 D when 0.3 logMAR as cutoff value. Relative DOF considering a drop of 0.1 logMAR from maximum visual acuity was 2.57 ± 0.82 D, and 1.27 ± 0.70 D when a drop of 0.04 logMAR was considered. Visual acuities obtained 3-months after the surgery were 0.03 ± 0.13, - 0.05 ± 0.06, 0.03 ± 0.08 and 0.04 ± 0.08 logMAR for uncorrected and best-corrected for distance, and best distance-corrected for intermediate and near distances, respectively. Average response to visual satisfaction queries was 8.24/10 at distance, 8.04/10 at intermediate, and 7.88/10 at near. CONCLUSIONS: Patients implanted with this trifocal IOL showed a significant improvement in visual acuity at different distances providing wide absolute and relative DOF values. The outcomes demonstrate that this lens is predictable yielding good patient satisfaction rates.

Long-Term Results of Postoperative Rescuing of Inverted DMEK Grafts: Two Case Reports.

PURPOSE: The purpose of this study was to report the clinical outcomes of postoperative repositioning of 2 inverted Descemet membrane endothelial keratoplasty (DMEK) grafts in 2 patients with endothelial dysfunction. METHODS: Two patients underwent DMEK surgery in a tertiary referral corneal clinic. Initial surgery was performed by 2 different corneal surgeons, and a third surgeon repositioned both cases. In the early postoperative period, partial and subtotal detachments were observed at slitlamp and inverted graft orientation was confirmed by anterior segment optical coherence tomography. In both cases, uneventful reposition of the inverted graft was performed by an experienced DMEK surgeon on days 2 and 9 after initial DMEK surgery. RESULTS: Repositioning surgery was successful in both patients. The Moutsouris sign was used to confirm proper orientation. One patient had total graft adherence at day 1 postrepositioning. The second patient required a rebubbling procedure, despite the correct orientation confirmed by using anterior segment optical coherence tomography. Visual acuity and corneal thickness were stable in both cases (case 1: 20/30, 567 µm; case 2: 20/80, 543 µm). Both patients had clear corneas and functional cell counts 2 years after repositioning (451 cells/mm 2 and 1052 cells/mm 2 ). CONCLUSIONS: Postoperative repositioning of an inverted DMEK graft may be a viable procedure to delay or prevent regrafting.

Clinical evaluation of the effectiveness of asymmetric intracorneal ring with variable thickness and width for the management of keratoconus.

PURPOSE: To evaluate the short-term clinical outcomes obtained with a new model of asymmetric intracorneal ring segments (ICRS) with variable thickness and base width in keratoconus. SETTING: Four ophthalmologic centers in Spain. DESIGN: Prospective multicenter longitudinal noncomparative clinical trial. METHODS: Thirty-one keratoconus eyes of 25 patients (aged 15 to 50 years) that underwent implantation of ICRS of variable thickness and base (AJL-pro+) in 4 Spanish centers were enrolled. Visual, refractive, topographic, aberrometric, and pachymetric changes were evaluated during a 3-month follow-up. Complications were also recorded. RESULTS: Statistically significant changes after surgery were observed in uncorrected distance visual acuity (P = .002) and corrected distance visual acuity (CDVA) (P = .005), as well as in spherical equivalent (P = .006). At 3 months postoperatively, no loss of 2 or more lines of CDVA was observed, whereas 48.4% (15) of eyes gained ≥1 line. Statistically significant changes were observed in the steepest and mean keratometric values (P ≤ .047) and in the magnitude of astigmatism (P < .001) of both anterior and posterior corneal surfaces. Likewise, a change to a less prolate shape of the anterior surface was found (P = .011). Primary coma was also reduced significantly at 1 month postoperatively (P = .001, mean reduction 40.1%). No serious implant-related complications occurred during the follow-up. CONCLUSIONS: The implantation of intrastromal asymmetric ring segments of variable thickness and base width in keratoconus corneas induces a significant anterior corneal flattening, leading to refractive changes, a significant reduction of its prolate shape and irregularity, and improvement in patient CDVA.

Detecting SARS-CoV-2 RNA in conjunctival secretions: Is it a valuable diagnostic method of COVID-19?

The main purpose of this study is to evaluate the presence of viral RNA of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in conjunctival swab specimen of coronavirus disease 2019 (COVID-19) patients with and without conjunctivitis to establish the diagnostic value of reverse transcription-polymerase chain reaction (RT-PCR) in each case and to describe its clinical characteristics. A cross-sectional study was conducted at the Hospital Clinico San Carlos of Madrid, Spain. Thirty-six subjects from the COVID admission unit with laboratory-confirmed SARS-CoV-2 infection were included. Conjunctival swabs were collected from 18 patients with conjunctivitis and 18 patients without conjunctivitis and RT-PCR was performed. Conjunctival swab was collected from both eyes of 36 patients (72 eyes), detecting SARS-CoV-2 RNA in conjunctival swab of two patients (5.5%). Among the 18 patients with conjunctivitis, only one of them (5.5%) showed positive results. Likewise, SARS-CoV-2 RNA was detected in one patient without conjunctivitis (5.5%). The mean age of the 36 patients was 67.9 years (range, 28-92 years) and the male-to-female ratio was 0.44 (16:20). The mean days since the onset of COVID-19 symptoms until conjunctivitis manifestation was 8 (range, 1-24 days). The mean duration of the conjunctivitis was 3 days (range, 1-7 days). SARS-CoV-2 RNA may be detected in conjunctival swabs of both patients with and without conjunctivitis. This study revealed the same rate of positive results amongst the group with and without conjunctivitis, suggesting that detecting SARS-CoV-2 in ocular fluids is not conditioned on the presence of conjunctivitis. The presence of SARS-CoV-2 RNA in ocular samples highlights the role of the eye as a possible route of transmission of the disease.

Tonometry after Intrastromal Corneal Ring Segments for Keratoconus.

SIGNIFICANCE: Reliable intraocular pressure (IOP) measurement after intrastromal corneal ring segments (ICRS) implantation is a challenge because of altered corneal morphology. In this study, IOP is measured with four tonometers, compared with Goldmann applanation tonometry (GAT) values and the influence of corneal parameters is established. PURPOSE: This study compares IOP measurements made using different tonometers in patients implanted with ICRS and assesses the effects of central corneal thickness (CCT), corneal curvature, and corneal astigmatism on the IOP measurements obtained. METHODS: In this cross-sectional study, IOP was measured using three different tonometers in 91 eyes of 91 patients with corneal ectasia implanted at least 6 months previously with ICRS. The tonometers tested were the TonoPen XL, Pascal dynamic contour tonometer (DCT), and iCare Pro rebound tonometer. GAT measurements were used as reference. Agreement among the IOPs provided by the different tonometers and the influence of corneal variables on the IOP measurements obtained were assessed using the Bland-Altman method, intraclass correlation coefficients, and multiple linear regression analysis. RESULTS: Mean IOP differences were GAT versus TonoPen XL -0.8 ± 3.07 mm Hg, GAT versus DCT -1.0 ± 3.26 mm Hg, and GAT versus iCare Pro 0.8 ± 2.92 mm Hg. Our multiple linear regression analysis identified CCT as a confounding factor affecting all the tonometer readings but DCT-IOP. CONCLUSIONS: In patients fitted with ICRS, IOP measurements made using the iCare Pro and TonoPen XL showed most agreement with GAT. Intraocular pressure measurements made by DCT were unaffected by corneal topographic factors though this procedure slightly overestimated GAT readings.

Uvemaster: A Mobile App-Based Decision Support System for the Differential Diagnosis of Uveitis.

Purpose: To examine the diagnostic accuracy and performance of Uvemaster, a mobile application (app) or diagnostic decision support system (DDSS) for uveitis. The app contains a large database of knowledge including 88 uveitis syndromes each with 76 clinical items, both ocular and systemic (total 6688) and their respective prevalences, and displays a differential diagnoses list (DDL) ordered by sensitivity, specificity, or positive predictive value (PPV). Methods: In this retrospective case-series study, diagnostic accuracy (percentage of cases for which a correct diagnosis was obtained) and performance (percentage of cases for which a specific diagnosis was obtained) were determined in reported series of patients originally diagnosed by a uveitis specialist with specific uveitis (N = 88) and idiopathic uveitis (N = 71), respectively. Results: Diagnostic accuracy was 96.6% (95% confidence interval [CI], 93.2-100). By sensitivity, the original diagnosis appeared among the top three in the DDL in 90.9% (95% CI, 84.1-96.6) and was the first in 73.9% (95% CI, 63.6-83.0). By PPV, the original diagnosis was among the top DDL three in 62.5% (95% CI, 51.1-71.6) and the first in 29.5% (95% CI, 20.5-38.6; P < 0.001). In 71 (31.1%) patients originally diagnosed with idiopathic uveitis, 19 new diagnoses were made reducing this series to 52 (22.8%) and improving by 8.3% the new rate of diagnosed specific uveitis cases (performance = 77.2%; 95% CI, 71.1-82.9). Conclusions: Uvemaster proved accurate and based on the same clinical data was able to detect more cases of specific uveitis than the original clinician only-based method.

Measuring Intraocular Pressure in Patients With Keratoconus With and Without Intrastromal Corneal Ring Segments.

PURPOSE: To compare intraocular pressure (IOP) measurements made using 5 tonometers in keratoconic eyes with and without intrastromal corneal ring segments. METHODS AND PATIENTS: This was an observational case series study. A total of 147 eyes of 147 patients with keratoconus, 74 of which had undergone corneal ring segment placement, were prospectively evaluated. IOP was measured using the tonometers Tonopen XL, Pascal dynamic contour tonometer, iCare Pro, ocular response analyzer (ORA), and Goldmann applanation (GAT) in random order. The Bland-Altman method was used to examine interinstrument agreement. Effects on readings of central corneal thickness, corneal curvature, and corneal astigmatism were assessed by multivariate regression analysis. RESULTS: Smallest mean IOP differences with GAT measurements in eyes without and with ring segments, respectively, were detected for iCare Pro [0.2 (2.9) mm Hg and 0.4 (3.0) mm Hg, P=0.914] and greatest differences for ORA Goldmann-correlated IOP [5.8 (3.3) mm Hg and 6.0 (3.1) mm Hg, P=0.363]. Best agreement with GAT was shown by iCare Pro (ICC=0.829; 95% CI, 0.721-0.896) and worse agreement by ORA corneal-compensated IOP (ICC=-0.145; 95% CI, -0.826 to 0.283). All but the dynamic contour tonometer readings were influenced by central corneal thickness, yet these measurements were affected by the presence of ring segments (P=0.017) and corneal astigmatism (P=0.030). Corneal curvature only affected ORA Goldmann-correlated IOP (P=0.029). CONCLUSIONS: All 5 tonometers provided reliable IOP readings in the keratoconic eyes regardless of the presence of corneal ring segments. iCare Pro readings were most consistent with GAT, whereas ORA readings were least consistent with this reference standard.

Measuring intraocular pressure after intrastromal corneal ring segment implantation with rebound tonometry and Goldmann applanation tonometry.

PURPOSE: The aim of this study was to compare intraocular pressure (IOP) measurements in patients with ectatic corneas after intrastromal corneal ring segment (ICRS) implantation using the Rebound tonometers (RBTs) Icare and Icare Pro, compared with Goldmann applanation tonometry (GAT) and to assess the influence of central corneal thickness (CCT), corneal curvature (CC), and corneal astigmatism (CA) on IOP. METHODS: This prospective cross-sectional study consecutively included 60 eyes of 60 patients with corneal ectasia having ICRS for at least 6 months from January 2011 to December 2013. All subjects underwent GAT, Icare, and Icare Pro IOP measurements in a random order, and CCT, CC, and CA evaluation using a Pentacam. The Bland-Altman method and multivariate regression analysis logistic method were used to assess intertonometer agreement and the influence of corneal variables on IOP measurements. RESULTS: Icare significantly underestimated IOP compared with GAT [GAT - Icare 1.2 ± 3.0 mm Hg, P = 0.002 (95% confidence interval, 0.5-2.0)], whereas Icare Pro showed no statistical differences compared with GAT [GAT - Icare Pro 0.1 ± 3.1 mm Hg, P = 0.853 (95% confidence interval, -0.7 to 0.9)]. Both RBTs presented good concordance with GAT (intraclass coefficient correlation > 0.6). All tonometer measurements were influenced by CCT values and age (P < 0.05); the number of ICRS implanted did not influenced IOP measurement with any of the 3 tonometers. CONCLUSIONS: Both RBTs could be an alternative to GAT in patients with corneal ectasia and ICRS; however, Icare Pro shows greater accuracy.

Intrastromal corneal ring segment implantation for high astigmatism after penetrating keratoplasty.

PURPOSE: To evaluate the safety and efficacy of intracorneal ring segments (ICRS) for high astigmatism after penetrating keratoplasty (PKP). SETTING: Department of Ocular Surface and Inflammation, Ophthalmology, Hospital Clínico San Carlos, Complutense University, Madrid, Spain. METHODS: This retrospective noncomparative study comprised eyes with high post-PKP astigmatism (>4.00 diopters [D]), contact lens intolerance, and a minimum follow-up of 24 months who had ICRS (Kerarings) implantation by mechanical stromal dissection. Corrected distance visual acuity (CDVA), refractive astigmatism, spherical equivalent (SE), surgically induced astigmatism (SIA), central corneal curvature, topographic corneal astigmatism, average corneal power, and complications were assessed. RESULTS: The mean CDVA was statistically significantly better postoperatively (0.23 +/- 0.21) than preoperatively (0.98 +/- 0.27) (P = .007); no eye lost CDVA. The mean refractive astigmatism decreased from 6.17 +/- 1.12 D to 4.04 +/- 1.67 D (P = .068) and the mean SE from -3.17 +/- 5.48 D to -0.12 +/- 2.40 D (P = .34). The mean SIA was 4.55 +/- 2.83 D. The mean central corneal curvature decreased from 46.28 +/- 1.73 D to 42.09 +/- 3.20 D (P<.01); the mean topographic corneal astigmatism, from 7.07 +/- 2.52 D to 4.48 +/- 2.00 D (P<.05) and the mean average corneal power from 45.92 +/- 1.59 D to 41.88 +/- 3.37 D (P<.01); all decreases were statistically significant. One patient developed deep vascularization in the lower temporal stromal channel that resolved after ICRS removal. One patient reported significant night halos. CONCLUSION: Implantation of ICRS for high post-PKP astigmatism reduced corneal curvature and topographic astigmatism, significantly improving CDVA.

Ultrasound biomicroscopy of silicone posterior chamber phakic intraocular lens for myopia.

PURPOSE: To study the intraocular position and anatomic relationships of PRL-III (phakic refractive lens) (PRL) posterior chamber phakic intraocular lens (PCP IOL) for high myopia using ultrasound biomicroscopy (UBM). SETTING: Centro Oftalmológico Real Vision, and Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid, Madrid, Spain. METHODS: Sixteen phakic myopic eyes that had had PRL implantation were examined by UBM 1 month after surgery. The PRL position, PRL-crystalline lens peripheral distance, and central distance between the corneal endothelium and the PRL were measured. RESULTS: Both haptics were on the zonule in 6 eyes, in the ciliary sulcus in 5 eyes, and impacted in the ciliary body in 1 eye. In the 4 remaining eyes, the haptics were in mixed positions. The mean PCP IOL crystalline lens peripheral distance in the minor axis was 588.1 microm +/- 232.5 (SD), and the mean PCP IOL-endothelium central distance was 2082.8 +/- 277.6 microm. CONCLUSIONS: Phakic refractive lens implantation should be done carefully because of the sulcus location of the haptics in many cases. This, with the iris-PRL contact, suggests caution for the long-term outcome.

Ultrasound biomicroscopy examination of posterior chamber phakic intraocular lens position.

OBJECTIVE: To better elucidate the in vivo position of the Collamer posterior chamber phakic intraocular lens (PCPIOL) and its relationship to the iris and the crystalline lens and to analyze possible variations over time. DESIGN: Prospective observational case series. PARTICIPANTS: Eighteen eyes of nine patients were included. INTERVENTION: A Staar Collamer implantable PCPIOL was implanted for the correction of high myopia. MAIN OUTCOME MEASURES: The eyes were studied with a 50-MHz ultrasound biomicroscopy UBM 840. The exact PCPIOL position and the distances between it and the crystalline lens were measured at 3, 6, and 12 months after surgery. RESULTS: There were no intraoperative complications. In 13 eyes (72.22%), contact between the PCPIOL and the crystalline lens was found at some time during follow-up. In 3 eyes (16.6%), central contact could be demonstrated. We also observed that the contact zone and its extension can vary over time. In 2 eyes, rotation of the lens was observed. CONCLUSIONS: We found contact between the PCPIOL and the crystalline lens in a high percentage of cases. There was also mobility of the lens in the posterior chamber, especially in the anteroposterior plane, and, as a consequence, both the contact zone and its extension would vary over time.