Long-term follow-up of leiske closed-loop anterior chamber intraocular lenses

To provide long-term follow-up on the rates of endothelial cell loss in eyes with retained closed-loop anterior chamber intraocular lenses (IOLs).

Private practices, Chicago, Illinois, USA.

In 1980 to 1982, 3 surgeons performed 587 intracapsular cataract extractions with implantation of Leiske closed-loop anterior chamber IOLs. During the prospective part of the study from 1991 to 1996, 59 patients with 83 eligible eyes were followed using specular microscopy and pachymetry. The mean follow-up of the prospective study was 41.9 months, or 12.9 years from the original cataract surgery.

No specific preoperative or postoperative factor except the behavior of the fellow eye (P =.022) predicted the rate of endothelial cell loss. During the prospective study, 6 patients required IOL exchange and corneal transplantation. The rate of corneal decompensation was heavily dependent on the initial measurement of endothelial cell density. Corneas with initial endothelial cell counts greater than 1000 cells/mm(2) had a decompensation rate of 1.5%, and corneas with counts of 500 cells/mm(2) or less had a decompensation rate of 57.1% (P <.01).

Clinical examination and serial measurements of endothelial cell density provide the most reliable methods for monitoring patients with closed-loop anterior chamber IOLs. Endothelial cell counts can predict the rate of corneal decompensation. Patients with endothelial cell counts greater than 1000 cells/mm(2) usually do not require an IOL exchange.