Visual results and complications following posterior iris-fixated posterior chamber lenses at penetrating keratoplasty.
We retrospectively reviewed the records of 13 patients with pseudophakic bullous keratopathy who had undergone penetrating keratoplasty combined with suturing of a posterior chamber intraocular lens (PC-IOL) with angulated haptics to the posterior iris using the four optic positioning holes. Corneal endothelial decompensation was associated with anterior chamber IOLs in nine cases, with iris-fixated lenses in three cases, and a subluxated PC-IOL in one case. Visual acuity was 20/40 or better in 46%, 20/50 to 20/100 in 31%, and 20/200 or worse in 23%. These visual results are comparable with those reported for other similar surgical series. In four of seven eyes that had preoperative peripheral anterior synechiae (PAS), postoperative extension of at least 2 clock hours occurred; progressive angle-closure glaucoma developed in two of the four. In all four eyes, the extension occurred in the region directly overlying the lens haptics. The angulated haptics of iris-sutured PC-IOLs may predispose to extension of PAS and development of progressive angle-closure glaucoma.
Chu
M W
MW
Cullen Eye Institute, Baylor College of Medicine, Houston, Tex.
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Koch
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D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D003316:Corneal Diseases / Q000601:surgery; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000209:etiology; D006801:Humans; D007498:Iris / Q000473:pathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D007910:Lenses, Intraocular / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity