To investigate the presence of apparent accommodation in monocular pseudopakic eyes and contact lens wearing monocular aphakic eyes, we measured it in 54 monocular pseudophakic eyes (54 patients) and 40 contact lens wearing monocular aphakic eyes (40 patients). The mean apparent accommodation was 1.68+/-1.25 diopters in monocular pseudophakic eyes and 1.74+/-0.73 diopters in contact lens wearing monocular aphakic eyes, and there was no statistically significant difference between them. Apparent accommodation was not related either to type of intraocular lenses or pupil size in pseudophakic eyes and not related to target size in aphakic eyes, but it was influenced by pupil size in aphakic eyes. In the group of patients aged between 45 and 55, accommodation in phakic eyes was significantly greater than apparent accommodation in contralateral contact lens wearing monocular aphakic eyes.
*Accommodation, Ocular ; Adolescent ; Adult ; Aged ; Aphakia, Postcataract/*physiopathology ; Child ; *Contact Lenses ; Humans ; Middle Aged

OBJECTIVE: To evaluate the therapeutic efficacy of suture-fixation of foldable intraocular lens for non-posterior-capsular aphakia. METHODS: Akreos intraocular lens (from Bausch-Lamb Company) were selected for operation in aphakia with non-posterior-capsule or less capsule supporting intraocular lens. Complications and visual acuity were observed. RESULTS: There was no significant complication in the operation. Choroidal detachment occurred in 2 eyes postoperatively. Visual acuity of 0.3 accounted for 56.67%, 76.67%, 86.67%, and 90% respectively on the first day, at 1 week, 1 month and 3 months after the operation. CONCLUSION Suture-fixation of Akreos intraocular lens is a good choice for non-posterior-capsular aphakia.
Adult ; Aged ; Aphakia ; surgery ; Aphakia, Postcataract ; surgery ; Female ; Humans ; Lens Implantation, Intraocular ; methods ; Lenses, Intraocular ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures ; methods ; Suture Techniques

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

We retrospectively evaluated the clinical characteristics and surgical outcomes of 20 pseudophakic retinal detachment (RD) patients (20 eyes) and 17 aphakic RD patients (17 eyes). Males were predominated in both groups. The time interval between cataract extraction and RD was 31 months on average in the pseudophakic group, 32 months with intact posterior capsule and 27 months with ruptured posterior capsule, and 148 months in the aphakic group. In 50% of cases with ruptured posterior capsule in the pseudophakic group, RD occurred within 1 year. The anatomic success rate was 95% in the pseudophakic group and 88% in the aphakic group. The most common cause of failure was the development of proliferative vitreoretinopathy. Visual acuities more than 20/40 after RD surgery were found in 13 pseudophakic (65%) and 6 aphakic (36%) eyes. Aphakic patients were more inclined to have silent RD than pseudophakic patients because of their poor visual acuity. Post-operative follow-up is required especially for the first 1 year in cases of damaged posterior capsule due to the high incidence of RD during this period.
Adult ; Aphakia, Postcataract/*etiology/surgery ; Comparative Study ; Female ; Humans ; Lens Capsule, Crystalline/injuries ; Lens Implantation, Intraocular ; Male ; Middle Aged ; Phacoemulsification/*adverse effects ; Pseudophakia/*etiology/surgery ; Retinal Detachment/*etiology/surgery ; Retrospective Studies ; Rupture ; Visual Acuity

PURPOSE: The purpose of this study was to evaluate the visual outcomes and complications of unilateral scleral fixation of posterior chamber intraocular lenses (SF-PCIOLs) in pediatric complicated traumatic cataracts without capsular support. METHODS: This study involved five eyes of five children who underwent unilateral SF-PCIOL. All patients had a unilateral complicated traumatic cataract associated with anterior or posterior segment injury. Visual acuity (VA), IOL position, and postoperative complications were assessed during follow-up. RESULTS: The mean age of patients at the time of SF-PCIOL was 90 months (range, 66-115). The mean duration of follow-up time after surgery was 22 months (range, 5-55). In all patients, the best-corrected VA was either improved or was stable at last follow-up following SF-PCIOL implantation. There were no serious complications. CONCLUSIONS: Unilateral scleral fixation of PCIOL can be a safe and effective procedure for pediatric, unilateral, complicated traumatic cataracts without capsular support in selected cases.
Anterior Eye Segment/injuries ; Aphakia, Postcataract/*surgery ; Cataract/*etiology/physiopathology ; Child ; Child, Preschool ; Endophthalmitis/etiology ; Eye Injuries/*complications ; Female ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular/*methods ; Male ; Postoperative Period ; Retrospective Studies ; Sclera/*surgery ; *Suture Techniques ; Visual Acuity

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