Current concepts in posterior chamber lens technology.
Although extracapsular cataract extraction and posterior chamber lens technology is of unrivaled safety and efficacy, the following aspects command considerable attention: chronic postoperative inflammation, inhibition of posterior capsular opacification, facilitation of YAG-laser posterior capsulectomy, prevention of ultraviolet radiation exposure, and sulcus versus capsular-bag fixation of posterior chamber lenses. The differential diagnosis of lens-induced and intraocular-lens-induced inflammation is presented, along with recommendations for the treatment and management of the second eye. Use of the complete laser-ridge lens to create a barrier for migrating cells capable of causing posterior capsular opacification is discussed. Using it to create a space between the posterior surface of the optic and the posterior capsule to facilitate YAG-laser posterior capsulectomy is also described. The status of ultraviolet blockers in intraocular lenses is discussed. The transition to capsular-bag fixation is recommended based on the following problems with sulcus-fixated lenses: mechanical disruption of the blood-aqueous barrier with release of inflammatory mediators, hemorrhage from or obstruction in the major arterial circle, the danger of polypropylene in metabolically active tissue, and the posterior iris chafing syndromes.
D002387:Cataract Extraction / Q000009:adverse effects; D003937:Diagnosis, Differential; D006801:Humans; D007249:Inflammation; D007834:Lasers; D007910:Lenses, Intraocular / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis; D011832:Radiation Injuries / Q000517:prevention & control; D014466:Ultraviolet Rays