Background: Surgical correction of aphakia without capsular support continues to be a challenge. Improvements in the technology of cataract surgery have provided advancements in techniques in surgical management of aphakia. Locally, we have limited data on the outcomes of the different intraocular lenses used in aphakia. Objective: This study aimed to determine visual outcomes and complications associated with different techniques of intraocular lens implantation in the absence of capsular support. Methods: We reviewed the medical charts of 207 patients who underwent intraocular lens implantation without capsular support. Excluded were patients with incomplete follow up, pediatric patients, and lost records. Best corrected visual acuity at day 1, 1st month, 3rd month and 6th month postoperatively, and the complications were noted. Results: Mean age was 60 and 51% (n=105) were females. The mean follow-up time was 9.33 ± 0.71 months. Loss of capsular support was most frequently caused by intraoperative complication (n=146, 70%) and trauma. Retropupillary fixation iris claw intraocular lens was frequently used (n=93, 44.9%). Across all patients, visual acuities showed excellent outcomes with 20/50 or better. Across IOL types, the most frequent postoperative complication was increase in IOP. Statistically significant results were set at P <0.05. Conclusion There is a notable preference towards iris claw retropupillary lenses through time. Iris claw lenses showed the shortest operative time. All intraocular lenses used in aphakia showed comparably good postoperative visual acuities, except for the superior visual acuity trend seen among retropupillary iris claw and anterior chamber IOL groups. Complications included elevated intraocular pressures, corneal edema, and pigment dispersion.
Aphakia ; Philippines

From 1996 to 1998, secondary IOL implantation after traumatic cataract surgery was performed on 60 patients (60 eyes) of the age ranged from 5 to 56 years with a follow-up period of 3 to 18 months. Interval between cataract surgery and secondary IOL ranged from 7 days to over 2 years. Basing on the state and the size of the posterior capsule, patients were divided into 3 groups. IOL was implanted in posterior chamber: 32 eyes, anterior chamber: 3 eyes, and scleral fixation of posterior chamber: 25 eyes. Postoperative visual acuity was 0.2 or better in 53 eyes (88.33%) and 0.1 or worse in 7 eyes (11.67%). Post-operative complications include retinal detachment with fibrous vitreous: 1 eyes, fibrous membrane formation: 4 eyes, capsular opacification: 6 eyes, dislocations of IOL: 7 eyes, intraocular hypertension: 2 eyes. Pupillary ascension, prolapsed vitreous, and peripheral anterior synechia were common conditions limiting the result. Secondary IOL implantation after traumatic cataract surgery seems to be a reasonable way to improve visual function and to prevent amblyopia.
Lenses, Intraocular ; Aphakia

There are several causes developing diplopia after cataract surgery. Among these causes, central fusion disruption may be developed in longstanding unilateral traumatic cataract and uncorrected aphakia. The pathophysiology is unknown, but time interval between sensory deprivation and optical correction is an important factor. The characteristic signs and symptoms are exotropic, hypotropic or excyclotropic deviation, and intractable diplopia with vertical bobbing movement of non-fixing eye, particularly near the angle of superimposition with prism or haploscopic device. The authors report two cases of central fusion disruption in longstanding unilateral traumatic cataract and uncorrected aphakia.
Aphakia ; Cataract ; Diplopia ; Sensory Deprivation

Epikeratophakia is a newly developed refractive corneal surgery for the correction of aphakic vision. Two aphakic patients have received hyperopic epikeratophakia grafts. Three months postoperatively, two patients had visual acuities of 0.6 without spectacle overcorrection. Epikeratophakia appears to be effective for the correction of adult aphakia.
Adult* ; Aphakia* ; Epikeratophakia* ; Humans ; Transplants ; Visual Acuity

The Clinical observation of a microphthalmic eye with primary congenital aphakia and another eye with congenital cataract in a 19-year-old girl is reported.
Aphakia* ; Cataract ; Female ; Humans ; Young Adult

We performed treat the 41 eyes of rhegmatogenous retinal detachment to scleral encircling.The causes of retinal detachment were unidentifiable breaks (10 eyes), high myopia (8 eyes), pseudophakia or aphakia (8 eyes), giant tear (8 eyes)and multiple holes (7 eyes). Overall the reattachment ratewas 80.5% (33/41 eyes). The anatomic success rate was relatively high (85.7%)in eyes with giant tear, high myopia and multiple hole but relatively low in eyes with breaks unidentified (60%) or pseudophakic and aphakic retinal detachment (75%). Among those 33 eyes, functional success was achived in 27 eyes (81.8%). We achieved higher functional success rate in pseudophakia or aphakia, multiple hole and high myopia (over 83.3%) but low functional success rate in unidentifiable breaks (66.7%)and giant tear (71.4%). Our results suggest other treatments such as pars plana vitrectomy should be considered to treat eyes with retinal detachment of breaks unidentified, although scleral encircling has been used conventially.
Aphakia ; Myopia ; Pseudophakia ; Retinal Detachment* ; Retinaldehyde* ; Vitrectomy

We have performed epikeratoplasty to correct the visual acuity in high myopia who are more than -8.0D and intolerant to the wearing of contract lens, and for the aphakic eyes. It has been also applied to supress the progression of keratoconus. Of 118 eyes performed from january 1989 to july 1992, a total of 90 eyes which could be followed up were subject to the review, including 66 high myopic eyes, 18 keratoconus, and 6 aphakic eyes. In myopic patients, uncorrected visual acuity was stable from a proeperative mean of 0.04 to 0.58 at 4 months. Spherical equivalent was stable from a preoperative mean of -13.99 to -2.01 at 4 months. In keratoconus patients with mean 10.1 months follow-tp, uncorrected visual acuity was changed from 0.05 to 0.33 Corrected viaual acuity was changed from 0.15 to 0.60, keratometry reading was changed from 55.87D to 45.92D. Of 6 aphakic eyes, spherical equivalent of 3 pediatric: aphakic eyes under the age of 3 was changed from +15.0D to +3.41, for the other 3 adult aphakic eyes, spherical equivalent was changed from +9.5D to +1.83D and uncorrected visual acuity was changed from 0.03 to 0.32. Epikeratoplasty is effective surgery applicable to the correction of myopia more than -8.0D, keratoconus, and aphakia.
Adult ; Aphakia* ; Epikeratophakia* ; Humans ; Keratoconus* ; Myopia* ; Visual Acuity

After the first description of epikeratoplasty for the correction of aphakia by Kaufman in 1980, the application of epikeratoplasty has been extended further to keratoconus and high myopia. Six epikeratoplasty for 5 eyes of high myopia and 1 eye of keratoconus were performed and followed upto average 4.9 months. All cases improved their uncorrected visual acuity and the preoperative best corrected visual acuity improved or had no change postoperatively except one case on the last visit. In the cases of high myopia, the mean preoperative spherical equivalent of -19.4D was corrected to average -0.23D with the range of -1.75D to +2.5D postoperatively. In the case of keratoconus, there was the mean decrease in 12.0D of myopia in terms of spherical equivalent and the cornea was flattened by over 8D in keratometry readings.
Aphakia ; Cornea ; Epikeratophakia* ; Keratoconus ; Myopia ; Reading ; Visual Acuity

After the first description of epikeratoplasty for the correction of aphakia, it has been widely used in high myopia and keratoconus for improvement of visual acuity. Seven epikeratoplasties were performed on five high myopia and two keratoconus patients showing intolerance to eye-glasses and contact lens, with the mean follow-up period of 9.7 months. In high myopia, mean spherical equivalent decreased from -15.90D to -2.05D postoperatively. In keratoconus, mean keratometric value decreased more than 4.94D postoperatively and the progression of disease stopped. All patients showed an imporvement in thei uncorrected visual acuity and best corrected visual acuity. In all cases, reepithelialization completed in 4-23 days (mean 14 days).
Aphakia ; Epikeratophakia* ; Follow-Up Studies ; Humans ; Keratoconus ; Myopia ; Visual Acuity

We implanted aniridia intraocular lenses (aniridia IOL) on three cases with complaint of glare caused by traumatic or congenital aniridias combined with cataract or aphakia. Aniridia IOLs were fixed by scleral fixation on one aphakia with traumatic aniridia, and at the ciliary sulcus on one aphakia with traumatic aniridia and one congenital aniridia with cataract. After follow-up of at least 2 months, visual improvement, absence of glare and cosmetic acceptance was observed without any complication in all cases.
Aniridia* ; Aphakia ; Cataract ; Follow-Up Studies ; Glare ; Lenses, Intraocular*