[Long-term outcome after implantation of various intraocular lenses through a corneal tunnel].
A prospective, randomized study was carried out to evaluate functional and biomicroscopic long-term results of different posterior chamber intraocular lenses (IOLs) over a period of two years after clear corneal cataract surgery.


METHODS
2 years after phacoemulsification through a temporal two-step clear corneal incision a total of 67 patients were examined. In 26 eyes (group A) a foldable plate-haptic silicone IOL (Chiron Adatomed, C10), in 25 eyes (group B) a foldable disc silicone IOL (Chiron Adatomed, 90D) had been implanted through a 3.5 (group A) or 4 mm (group B) corneal incision using a cartridge injector. In 16 eyes (group C) a one-piece PMMA-IOL (Pharmacia & Upjohn, 809C) had been implanted through a 5 mm incision. All eyes underwent functional and biomicroscopic examinations, as well as computerized videokeratographic analysis to obtain corneal topography data.


RESULTS
In group A uncorrected visual acuity valued 0.64 (+/-0.29 SD), in group B 0.59 (+/-0.24) and in group C 0.56 (+/-0.27). Median of uncorrected visual acuity was 0.6 for all groups. Corrected visual acuity was 0.81 (+/-0.29) in group A, 0.8 (+/-0.25) in group B and 0.83 (+/-0.3) in group C. Intraocular pressure (mm Hg) was 13 (+/-2.5) in group A, 14.7 (+/-2) in group B and 15.1 (+/-2.5) in group C. Fibrosis of the anterior capsular rim occurred in 42% of the cases. One eye demonstrated folds in the posterior capsule (group B). Posterior capsular opacification valued 11.9% for all groups. In one eye a Nd:YAG-capsulotomy had already been performed. In group A a decentration of more than 1 mm was objected in one case, in group B in two cases and in group C in one case, but no patient complained about any functional impairment. Two years postoperatively, no signs of a re-flattening in the incision area could be detected using difference mapping tools in the videokeratographic analysis.


CONCLUSIONS
Two years after implantation of foldable silicone IOLs and PMMA-IOLs via a temporal clear corneal tunnel incision after phacoemulsification only slight functional and morphologic differences between the three IOL-types could be observed.
Dick
B
B
Universitäts-Augenklinik Mainz.
Kohnen
T
T
Jacobi
F
F
Jacobi
K W
KW
D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D011474:Prosthesis Design; D012828:Silicones; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D012828:Silicones; D019904:Polymethyl Methacrylate