[Complication profiles of posterior chamber intraocular lenses IOL). An analysis of 586 foldable and 2077 rigid explanted intraocular lenses].
BACKGROUND
Foldable intraocular lenses (IOL) have become increasingly preferred choice for IOL implantation after cataract removal. However, both foldable as well as rigid IOLs are not yet complication-free and may need explanation.


METHODS
A total of 2663 explanted posterior chamber IOLs (PCIOLs) were accessioned at the Center for Research on Ocular Therapeutics and Biodevices between January 1988 and September 2000. The lenses were examined grossly using a Leitz/Wild M-8-Zoom stereomicroscope. The clinical reasons for explanation were documented for foldable as well as for rigid lenses.


RESULTS
Of a total of 2663 explanted PCIOLs, 586 were foldable lenses and 2077 were rigid PMMA lenses The most frequent reason for explantation of all 2663 IOLs studied was decentration/dislocation. Optic and haptic damage and posterior capsule rupture were significantly more often a reason for explantation in several foldable designs compared to rigid PCIOLs. Whereas rigid designs lead more often to corneal decompensation. The percentage of explanted IOLs because of inflammatory reactions decreased significantly from 1994 to 2000.


CONCLUSIONS
The complication profiles of rigid and foldable IOLs revealed some apparent differences due to the nature of the IOL biomaterials and designs. IOL optic/haptic damage was a common complication for foldable IOLs, whereas it was only discovered in single digits for rigid PMMA IOLs. The possible explanation for this is, that the soft and flexible biomaterials, from which all the foldable IOLs were manufactured, are easier to be damaged during folding, unfolding and insertion procedure. In our opinion this relative disadvantage of foldable IOLs is by far outweighed by the numerous advantages of the small incision cataract surgery. The decreasing inflammatory reactions can be explained by advances in surgical techniques, especially the secure in-the-bag fixation of IOLs.
Schmidbauer
J M
JM
Center for Research on Ocular Therapeutic and Biodevices, Medical University of South Carolina, USA.
Apple
D J
DJ
Auffarth
G U
GU
Peng
Q
Q
Pandey
S K
SK
Werner
L
L
Escobar-Gomez
M
M
Vargas
L G
LG
D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D019904:Polymethyl Methacrylate; D012307:Risk Factors
D019904:Polymethyl Methacrylate