Anterior chamber IOLs have evolved over time

November 15, 2004

There are many locations within the eye that an IOL can be placed. Most often, lenses are placed in the bag, but they may be placed in the sulcus, sewn into the posterior chamber, or sewn into or clipped onto the iris. Another location can be in the anterior chamber. Let's look at the evolution of anterior chamber IOLs (AC IOLs) in this month's column.

There are many locations within the eye that an IOL can be placed. Most often, lenses are placed in the bag, but they may be placed in the sulcus, sewn into the posterior chamber, or sewn into or clipped onto the iris. Another location can be in the anterior chamber. Let's look at the evolution of anterior chamber IOLs (AC IOLs) in this month's column.

Inflammation was an early problem with the implants; anti-inflammatory medications had yet to be developed. Pupillary occlusion and secondary glaucoma were not uncommon. Later complications included secondary membranes and lens dislocations, which occurred primarily due to the weight and size of the lens. By 1960, most AC IOLs were abandoned because of a cited 13% to 15% incidence of dislocations and an 8% to 10% incidence of glaucoma.

Some modifications Choyce's lenses were termed Mark lenses. The Mark was first implanted in 1956 as a modification of Strampelli's lens, and his Mark VIII lens was first implanted in 1963; this was his most used implant. It was a ridged, quadrangular lens having a 6-mm optic, four-point fixation, and a chord length of between 11 and 14 mm. Choyce used this lens for secondary implants in either extracapsular or intracapsular extractions.

Colored lenses were also used inpatients with albinism to minimize the iris transillumination.

In 1977 and 1978, a number of cases with complications of bleeding, elevated IOP, and iritis were reported in the literature. These reports increased, and a syndrome-the uveitis, glaucoma, and hyphema (UGH) syndrome-was described.