An analysis of semiflexible, closed-loop anterior chamber intraocular lenses

We present the pathologic and scanning electron microscopic findings from 44 semiflexible, all polymethylmethacrylate, anterior chamber intraocular lenses (IOLs). These IOLs, which have round, small diameter, closed loops were removed following a variety of complications, including uveitis and/or the uveitis-glaucoma-hyphema syndrome, secondary glaucoma, pseudophakic bullous keratopathy, cystoid macular edema, erosion into uveal tissue (with and without oval pupil), and iris neovascularization. Over 200,000 of these lens styles have been implanted. Even though the number of these IOLs accessioned in our laboratory is small, we feel this analysis documents some of the problems that may be encountered with this IOL design. Many of the complications documented in our series resulted in severe visual loss. In addition to tissue damage that appeared secondary to the mechanical tissue-to-implant interface, other causes of complications included variations in surgical technique, implantation into eyes with preexisting disease (including eyes that had undergone previous surgery), and damage to tissue that occurred during IOL removal.