A study of 200 cases of anterior chamber implants

In a series of 200 eyes with Choyce or Leiske style anterior chamber implants followed for an average of 19 months, final visual acuity averaged 20/30. Eighty-four percent of patients were 20/40 or better and 8% 20/100 or worse at the end of the period of observation. Cystoid macular edema occurred in 17% with most cases occurring during the first seven months. Visual loss averaged two lines and duration averaged eight months. All but one patient with adequate follow-up recovered. Cystoid macular edema appeared to be more frequent in patients who were "blinkers." The incidence of "new" glaucoma in this study was 2%. Ovalling of the pupil occurred in 46% of eyes, more frequently late than early. Early development of ovalling was more likely to be associated with imperfect implant positioning than was late. Imperfect implant position occurred in 40% of cases and inadequate early fixation resulting in propellering or rotation in 16%. Rotation was not associated with imperfect implant position. No cases of severe iritis were encountered. Pigment dispersion and vitreous herniating anterior to the optic were observed in a few eyes. No cases of corneal decompensation occurred although two eyes had minor to moderate changes. The incidence of subsequent procedures was a low 6%, helping to contribute to the high ratio of patient satisfaction. Mild tenderness and glare were the chief postoperative symptoms.