Long-term follow-up of secondary flexible, open-loop, anterior chamber intraocular lenses.

PURPOSE: To evaluate the long-term results of secondary implantation of modern flexible, open-loop, anterior chamber intraocular lenses (IOLs).

SETTING

Department of Ophthalmology, National University Hospital, Oslo, Norway.

METHODS

This prospective study comprised 18 patients (20 aphakic eyes) who had secondary IOL implantation from January 1990 to May 1992. In an earlier report, these patients were followed for 4 months. The patients were reexamined in October 1998. The mean follow-up was 93.8 months +/- 6.0 (SD). Two patients had died. No others were lost to follow-up. The intraocular pressure (IOP) in the remaining 16 patients (18 eyes) was compared to that 4 months postoperatively. Visual acuity was compared to the preoperative measurements. A complete slitlamp examination was performed, and complications were noted.

RESULTS

There was no statistical decrease in visual acuity during the follow-up. The mean IOP was 16.6 +/- 5.7 mm Hg (range 8 to 27 mm Hg) in 1998 and 13.4 +/- 3.4 mm Hg (range 7 to 19 mm Hg) 4 months postoperatively. The difference was statistically significant (P =.037). Corneal pathology was seen in 3 eyes, 1 of which had developed corneal decompensation. One patient had surgery for retinal detachment 4 years postoperatively. The pupil was deformed in 5 eyes.

CONCLUSIONS

This long-term study demonstrates that secondary implantation of flexible, open-loop, anterior chamber IOLs is safe in selected eyes. Anterior chamber IOLs should not be used in eyes with corneal problems and should be used with caution in eyes with glaucoma. These patients require close, continued observation to look for late complications such as IOP elevation.