Posterior chamber pseudophakia

Anatomically, the most physiological type of implant is that of the posterior chamber of the eye. After a brief historical review of these implants, two models differing by their loops are compared, these being either in the form of a J with narrow extremities or in the form of a C. The latter model possesses definite advantages. Firstly, the point of pressure on the lens capsule is less concentrated, reducing the pressure exerted by the loops and thus avoiding rupture of the zonular ciliaris, Secondly, contact in the form of an are prevents movement of the implant around its axis, a factor favorizing capsule slipping. Thirdly, the improved pressure distribution of the loops resulting from their greater flexibility also prevents the "windscreen wiper syndrome", providing improved stability of the implant. The technique employed avoids all contact taking place with the endothelium. The upper loop is placed in position after closure of the incision. Results in 1532 cases were very positive, and studies are currently being conducted with an implant with four loops in which the optic is within the posterior chamber, and which could be positioned after intracapsular extraction. A system of irrigation-aspiration is described which employs a fine curved canula that is easier to manage and permits improved cleaning of the capsule. Emphasis is placed on the need for narrow, deep, corneal sutures to reduce postoperative astigmatism.