[Experiences with disc lenses composed of silicone]

Our study presents the results with a silicone disc-lens (Adatomed 90D) over a postoperative period of 18 months. It includes 47 patients, 42 could be reexamined. The implantation was done after continuous circular capsulorhexis and phacoemulsification with a Faulkner-folder directly into the capsular bag. The implantation was sometimes difficult. Skill and experience of the surgeon are required. The IOL springs forth of the implantation forceps, which can lead to traumatization of the capsule and the iris. Three times the posterior capsule ruptured, in two cases the implantation was stopped because of vitreous pressure and the risk of rupturing the capsule. In 6 cases the rim of the anterior capsule ruptured during the implantation. Postoperatively one IOL had a sulcus position, all other IOLs were in the capsular bag. A deposit of viscoelastic substance (Healon) between the IOL and the posterior capsule in 34 cases (72%) was remarkable. In 14 cases (33%) it remained for 18 months. 16 times (38%) regeneratory after-cataract reached the central part of the capsule. The visual disturbance was different, in 6 cases (14%) a YAG-laser-capsulotomy was performed. An influence of the deposit of viscoelastic substance on the development of posterior capsule opacification could not be proved. 17 IOLs (40%) were minimally decentrated upwards. Only 11 cases (26%) had an excellent mydriatic pupillary reaction. The reason is not clear. 10 eyes (24%) developed iridocapsular synechia, 22 eyes (52%) foreign body giant cells and 20 eyes (48%) dispersed pigment on the IOL surface. The giant cells did not diminish.(ABSTRACT TRUNCATED AT 250 WORDS)