Evaluation of 150 consecutive cases of poly HEMA posterior chamber lenses implanted in the bag using a small-incision...

We report the results of 150 capsular bag implantations of the IOGEL PC-12 hydrogel lens. Mean follow-up was seven months. Following capsulorhexis and phacoemulsification, a Faulkner folder was used to insert the lens through a 3.5 mm to 4.0 mm scleral tunnel incision. Initially, a number of surgical complications were encountered. Because of increasing experience and modified instrumentation and technique, these did not occur in the later cases. Visual results were good, all eyes gaining a best case visual acuity of 20/40 or better and 97% achieving 20/25 or better. Morphological results were satisfactory. Generally the lenses remained centered and at a distance from the iris. Retention of viscoelastic substance or debris between the lens and the posterior capsule, occasionally observed at the start of the series, has been avoided by retrolental aspiration. Persistent pigment dispersion, which was observed when the lens had been implanted in the sulcus, was not seen. Tolerance of the lens material was generally satisfactory. There were six cases (4%) of fibrinoid uveitis, which is a relatively high incidence. From our experience and results we conclude that this implantation procedure allowed controlled insertion and placement of the IOGEL lens, provided that adequate instrumentation and technique was used; visual performance was comparable to that of poly(methyl methacrylate) lenses; capsular bag fixation furnished satisfactory morphological results, provided an adequately shaped capsulorhexis was performed.