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Year : 1982  |  Volume : 30  |  Issue : 5  |  Page : 455-456

Simplified approach to intraocular lens implant in cataract surgery-a preliminary report

Ophthalmology Command Hospital (Western Command) Chandigarh, India

Correspondence Address:
J Luthra
Ophthalmology Command Hospital (West Command) Chandigarh
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How to cite this article:
Luthra J. Simplified approach to intraocular lens implant in cataract surgery-a preliminary report. Indian J Ophthalmol 1982;30:455-6

How to cite this URL:
Luthra J. Simplified approach to intraocular lens implant in cataract surgery-a preliminary report. Indian J Ophthalmol [serial online] 1982 [cited 2023 Dec 2];30:455-6. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1982/30/5/455/29226

A preliminary report of simplified tech nique of implantation of an iris-plane intra ocular lens (Copeland lens) cambined wits intracapsular extraction based on the experi­ence of 25 cases is presented.

  Materials and methods Top

25 patients, all over 65 years of age had advanced or mature unilateral cataract and were poor contact lens condidates. They were free from following conditions :- Endo­thelial dystrophy, shallow anterior chamber, Glaucoma, Diabetes, Abnormal pupil or Iris, High Myopia and previous Retinal detach­ment.

The Copeland lens is an all Polymethy­lemethacrylate lens of the shape of a symme­trical cross with the 4 haptics in the same plane as the round optical portion. The optical portion is approximately 0.38 mm thick. and supports are 0.1 mm thick. It is 9 mm from tip of one haptic to the trip of opposite haptic. It is available in the powers of 16, 17.5, 19 and 20.5 diop­tres. It is entirely supported by iris and is hinged securely in the place of the pupil and is immobile even with extensive eye move­ment. The power of the implant is predic­ted from the refractive error of the other eye.

  Surgical technique Top
Patient kept on local antibiotics 72 hours before surgery. All surgeries have been conducted under local anaesthesia. Hypo­tony is ensured by oral glycerol and prolon­ged bulbar massage. Pupil is kept dilated with I drop of homatropine 2% and 1 drop of Drosyn 10%. If too widely dilated acety­lcholine is used to constrict the pupil prior to insertion of the plant. Anterior chamber is opened with broken razor blade enlarged with scissors after a fornix based flap. The lens is extracted intracapsularly using a cryo extractor. The intraocular lens is inserted with 6 0' clock haptic behind the iris and 2 horizontal haptics in front. Then the iris at 12.0' clock was gently lifted over the 12.0' clock haptic. The wound was closed by multi­ple sutures with 9.0 silk to make it water tight.

Post operatively oral steroids is used for 10 to 14 days as a routine. Sometimes for 3 weeks if necessary.

Surgeon used a operating loupe for magnification.

  Discussion Top

The follow up period is only 2 to 9 months in the present series. Lens dislocation and retinal detachment were not encountered; severe iritis occurred in first four cases, pro­bably because of excess iris manipulation or vitreous contact. Wound leak, filtering bleb and flat chambers did not occur; slight vttreous loss was seen through the peripheral iridectomy in one case for which partial anterior vitrectomy was done. Steroid glaucoma occurred in 2 cases which responded to treat­ment satisfactory. Pupillary membrane occurred in 2 cases, out of which one had corneal oedema.

Cystoid macular edema was seen in one patient only, which responded to systemic steroid given for 8 weeks.

Out of 25 cases, 19, cases have upto date visual acuity 6/12 or better with full field of vision. Another 5 cases have VA from 6/ 18 to 6/36.

This lens is relatively easier to insert when first starting intraocular lens surgery. The operation can be performed with the help of good corneal loupe. It does not require suture material to secure the implant. The simplicity of insertion and lack of significant complication make it a suitable implant under Indian conditions. However, long term follow up and further investigations are needed to put up the value of IOL implant surgery in its true perspective.

  Acknowledgements Top

I wish to thank profusely Brig. M.I. Hasan for his constant encouragement and for his kind permission to read this paper.

  Summary Top

Copeland Iris-place intraocular lens implant was carried out in 25 patients. Visual results are gratifying. Technique is relatively easy when first starting intraocular lens surgery combined with standard intracapsular cataract extraction. It can be done with a good loupe, when the facilities of a microscope are not available.


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