ABSTRACT
PURPOSE: To assess potential problems in monitoring glaucoma status in pseudophakic patients in whom the intraocular lens (IOL) has undergone varying degrees of opacification. METHODS: Data was collected by retrospective review of the notes of such patients, who had received a hydrophilic acrylic IOL, SC-60B-0UV, after primary cataract extraction by phacoemulsification. At first, among these, patients with glaucoma were identified and notes were reviewed to identify problems with patients in whom the IOL had undergone varying degrees of opacification. RESULTS: A total of 32 eyes with glaucoma were identified to have received the SC-60B-0UV IOL. Of these, 13 IOLs (40.6%) had undergone varying degrees of opacification. Eyes with the opacified IOLs showed decreased visual acuity (2.5 lines of Snellen acuity on average). For these eyes, visual field performance (as determined on automated field analyzers) and optic disc assessments were adversely affected giving a false impression of advanced glaucomatous field loss. CONCLUSION: In our experience, glaucoma monitoring is made comparatively more difficult in pseudophakic patients with cloudy IOLs. Problems are encountered during assessment of the glaucomatous optic disc due to poor view of the optic disc. On standard static automated visual fields, these opacified IOLs produce artefactual visual field defects making monitoring glaucoma and subsequent management more difficult.
Subject(s)
Cataract/complications , Glaucoma/diagnosis , Pseudophakia/complications , Aged , Aged, 80 and over , Artifacts , Disease Progression , False Positive Reactions , Female , Glaucoma/complications , Glaucoma/physiopathology , Humans , Lenses, Intraocular , Male , Middle Aged , Phacoemulsification , Prosthesis Failure , Pseudophakia/physiopathology , Retrospective Studies , Visual Acuity , Visual Field Tests , Visual FieldsABSTRACT
PURPOSE: To find out the incidence of intraocular lens (IOL) optic opacification in a suspect IOL. METHODS: Retrospective review of patients' notes 3-4 years postimplant. RESULTS: In all, 56 IOLs showed signs of opacification, resulting in reduced vision out of 181 lenses traced. CONCLUSION: Certain hydrophilic acrylic IOLs like the model in question (SC60B-0UV) show opacification of the IOL, which may impair the vision of pseudophakic patients. However, not all lenses of this variety exhibit this cloudiness. Factors affecting this phenomenon are not yet completely clear but may include changes in the UV absorbant material incorporated in the lens substance itself. We report a series of patients who had received this lens and experienced loss of vision due to opacification of the IOL. In a follow-up ranging from 1 to 4 years postoperatively, a higher incidence of postoperative opacification of this lens emerges, after comparison with existing literature. IOL exchange in such patients is the only option. However, this mode of treatment should not be offered lightly as results may be guarded at best even in the face of a technically satisfactory procedure.
Subject(s)
Cataract/physiopathology , Lenses, Intraocular , Postoperative Complications/physiopathology , Prosthesis Failure , Acrylates , Adult , Aged , Aged, 80 and over , Device Removal , Equipment Failure Analysis , Female , Follow-Up Studies , Humans , Male , Middle Aged , Phacoemulsification , Prosthesis Design , Visual AcuityABSTRACT
The merits of hydrogel as an intraocular lens material are that it is soft, foldable, hydrophilic, autoclavable and more biocompatible than polymethylmethacrylate (PMMA). Twenty eyes were implanted with a new hydrogel design after phacoemulsification. Fifty per cent achieved a corrected acuity of 6/5 and all achieved 6/9 with correction. Results confirmed an excellent biocompatibility of the material but two cases of asymptomatic decentration indicated the occasional instability within the capsular sac. For best results the hydrogel requires an intact capsulorrhexis with a diameter between 4.5 and 5.0 mm.
