[Why are aphakic anterior chamber intraocular lenses still implanted? Five-year incidence and implantation circumstances at the Hôtel-Dieu in Paris].
OBJECTIVE
To report incidence and circumstances of aphakic anterior chamber intraocular lens implantation.


METHODS
Retrospective study of medical charts of anterior chamber intraocular lens implantation in the Ophthalmology Department, Hôtel Dieu, Paris, from 1996 to 2000, investigating the number of anterior intraocular lenses (ACIOL) implanted, circumstances, and incidence during cataract extraction.


RESULTS
One hundred and forty-three ACIOLs (139 patients, 60 men, 79 women) were implanted. The mean age was 75.98+/-10.6 years [range, 35-96 years]. All ACIOLs were of open-loop design: open C-loop or Kelman lens. Four circumstances leading to ACIOL implantation were reported: extracapsular cataract extraction with intraoperative complications (94 cases), intracapsular cataract extraction (13 cases), secondary implantation (20 cases), and penetrating keratoplasty with ACIOL (9 cases). Since 1996, the number of ACIOLs implanted each year has decreased (p<0.01): 1.09% of cataract extractions performed in 1996 were implanted with ACIOLs and 0.43% in 2000. At the end of the 5-year period, 12,580 cataract extractions had been performed in our department, with a mean incidence of ACIOL implantation at 0.85%.


CONCLUSIONS
ACIOLs continue to be implanted in some cases in the absence of capsular support. Because of endothelial complications, they must be reserved for elderly patients. Endothelial surveillance using specular microscopy remains indispensable.
Girard
A
A
Service d'Ophtalmologie, Hôpital Hôtel-Dieu, 1, place du parvis Notre-Dame, 75181 Paris Cedex 04, France.
Ellies
P
P
Bejjani
R A
RA
Assaraf
E
E
Renard
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber; D002387:Cataract Extraction / Q000706:statistics & numerical data; D004727:Endothelium / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D015948:Keratoplasty, Penetrating / Q000706:statistics & numerical data; D019654:Lens Implantation, Intraocular / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D008875:Middle Aged; D010297:Paris; D019591:Pseudophakia; D012189:Retrospective Studies