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Secondary intraocular lens implantation: eight year experience
J M Hayward1, B A Noble, N George
1Eye Department, Leeds General Infirmary.
Objective:
To investigate the outcome of secondary intra-ocular lens implantation. Neither a requirement for vitreous surgery nor previous complicated eye surgery/trauma was considered necessarily to be a contra-indication.
Design:
Retrospective Study. Recruitment was achieved by examination of operating theatre records.
Setting:
Teaching Hospital.
Patients:
52 out of 54 consecutive cases in whom a secondary lens had been implanted from 1982-1989 under the care of one consultant (BAN).
Interventions:
The medical records of all patients were reviewed and data collected for 52 of the total of 54 patients.
Main Outcome Measures:
Visual acuity and major complications.
Results:
77% of eyes retained the same Snellen visual acuity or better than that pre-operatively and 88% were within one line or better. The Mann Whitney U-test showed that neither vitreous manipulation at the time of secondary lens implantation nor a previous history of trauma had a significant effect on the change between pre- and post-operative Snellen visual acuity. Only one patient developed a retinal detachment and eight had cystoid macula oedema although in only one patient did this account for a final decrease in post-operative visual acuity of more than one line. The most common complication was an intense post-operative uveitis (35%) leading in some cases to indefinite low dose topical steroid treatment (21%).
Conclusions:
This technique gives good visual results, even in the disorganised eye, providing the vitreous is adequately managed. However there is a significant complication rate which should be discussed with the patient before undertaking surgery.