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. 2001 Oct;85(10):1198–1202. doi: 10.1136/bjo.85.10.1198

Primary polypseudophakia for cataract surgery in hypermetropic eyes: refractive results and long term stability of the implants within the capsular bag

H Eleftheriadis 1, A Sciscio 1, A Ismail 1, C Hull 1, C Liu 1
PMCID: PMC1723740  PMID: 11567964

Abstract

AIM—To determine the long term visual and refractive results, and stability and complications of primary polypseudophakia using poly(methylmethacrylate) (PMMA) intraocular lenses (IOLs) for cataract surgery in hypermetropic eyes.
METHODS—Prospective study of 15 short or hypermetropic eyes undergoing phacoemulsification with primary polypseudophakia with two PMMA IOLs implanted within the capsular bag.
RESULTS—The spherical equivalent was reduced from a mean +4.87 (SD 3.00) dioptres (D) to −0.12 (1.40 D), and the deviation from the intended refraction was +0.005 (1.30) D, 23.6 (12.36) months post-implantation. The deviation from intended refraction was not statistically significant (p = 0.989; paired t test). Postoperative best corrected visual acuity (BCVA) was 6/12 or better in all eyes without macular or optic nerve co-morbidity. Interlenticular opacification (ILO) in the form of peripheral Elschnig pearls was seen in four (26.67%) eyes. A new type of ILO in the form of usually pigmented deposits in the central interface developed in five (33.33%) eyes and resulted in the appearance of Newton's rings in three. None of the eyes with ILO had any loss of BCVA or hyperopic shift. Six (40%) eyes were within 1 D from the intended refraction and 14 (93.33%) within 2 D. There was no statistically significant difference in the accuracy of the two intraocular lens calculation formulas used (SRK II and SRK/T).
CONCLUSION—Peripheral Elschnig pearl-type ILO can occur as a late complication of primary in the bag implantation of two PMMA IOLs. A new type of ILO is described. Both types of ILO have not to date resulted in deterioration of visual acuity in our cohort. Use of appropriate biometry techniques and IOL calculation formulas may yield more accurate refractive results.



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Figure 1  .

Figure 1  

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(A) Slit lamp photograph of case 9 demonstrating mild anterior capsular fibrosis. (B) Slit lamp photograph of case 3 demonstrating posterior capsular thickening. Despite an eccentric anterior capsulorrhexis, the two intraocular lenses remain well centred and the two sets of haptics aligned. (C) Slit lamp photograph of case 1 demonstrating a small YAG laser posterior capsulotomy in an otherwise opacified posterior capsule. (D) Slit lamp photograph of case 14 demonstrating an eccentric anterior capsulorrhexis and well centred optics and parallel haptics. (E) Slit lamp photograph of case 1 showing peripheral interlenticular opacities in the form of Elschnig pearls. (F) Slit lamp photograph of case 15 showing pigmented clumps near the visual axis in the interlenticular space. We have not been able to photograph the associated Newton rings satisfactorily.

Figure 2  .

Figure 2  

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Montage of ultrasound biomicroscopy of the anterior segment of case 1 showing two intraocular lenses within the capsular bag.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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