|Year : 1984 | Volume
| Issue : 6 | Page : 494-495
Experiences with intraocular lens implants
Nalanda Medical College & Hospital, Patna, India
Nalanda Medical College & Hospital, Patna
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sinha A. Experiences with intraocular lens implants. Indian J Ophthalmol 1984;32:494-5
The idea of intraocular lens implant was conceived in order to remove mainly the difficulties of monocular aphakia. The aphakic glasses are not tolerated optically and physically by many and hence enormous interest has been created by many ophthalmologists about intraocular lens implant surgery. ,,.
With the above enthusiasm, I.O.L. implant surgery was undertaken. In a short period 24 cases have been undertaken.
| Materials and methods|| |
A great consideration regarding the selection of patients for I.O,L. implant was given. It was decided to include more of female patients, and all elderly patients above the age of 60 years initially but later as experience and confidence gained the age group of the patients included in this study were brought down to 50 years. Thirdly patients residing in the nearby places of the hospital were included so that they regularly attended follow up clinics.
In the first stage I.O.L. implants with fixed hard loop anterior chamber fixation were used. One case had Sputnik implant done. Later anterior chamber implants with flexible loops similar to Pannu Lens manufactured by Canadian firms were used. In one case Shepard lens with four anchoring hooks were used.
In this small series it was observed that uveitis is very common prolonged complication of this surgery. But this uveitis is very easily manageable by subconjunctival and systemic administration of corticosteroids. But in two cases of uveitis the eyes were lost because of heavy coagulum formed in the whole A.C.
There were two cases which developed secondary glaucoma. In the beginning it was thought it to be a result of uveitis, but the raised tension persisted even when the eyes had become white. The reason for precipitating glaucoma could be that they were either potential cases of glaucoma which was not detected on routine examination for cataract operation, or the implant might have triggered some factor to disturb the aqueous outflow facility. On long term followup the I.O.P. was well controlled with medical treatment.
One case with Sputnik implant of I.O.L, showed migration of the implant from central place to upper inner quadrant.
In all these cases the uncorrected visual acuity was no better than 6/24-6/18 and best visual acuity was 6/12. Most of the patients needed small myopic corrections. With the Sputnik lens the patient could read at near distance without any near vision correction. Probably the reason being the lens moved anteriorly on leaning the head down. This phenomenon has been described as Pseudo-accommodation.
Since most of the lenses were complementary given from the manufacturers in our country and few from colleagues abroad there was not much choice regarding preoperative measurements of optical power of lens.
In my opinion from economic point of view and lack of regular ophthalmic checkup I.O.L. is not meant for our poor country. None of the government hospitals are in a position to supply I.O.L. free of cost and many of the patients in private are reluctant to buy these costly implants and adding extra expenses at the top of regular cataract operation expenditure.
| Summary|| |
Data of the I.O.L. implant surgery is presented.
| References|| |
Akira MOmse, 1981, Afro-Asian J. Ophthalmol 1:17
Binkhorst, C.D. Nygaard. P. and Loones L.H, 1978, Amer. J. Ophthalmol 85 : 597
Galin, M.A.L.L. Fetherolf, E.C., Obstbaum, S.A. and Sugar, A, 1979, Amer. J. Ophthalmol 88 : 93.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]