الفهرس | Only 14 pages are availabe for public view |
Abstract The aim of this work was to evaluate the effects of posterior chamber intraocular lens implantation on the angle structures. This work included 30 eyes (of 28 patients) which were all operated upon by extracapsular cataract extraction technique and PCIOL implantation in Benha ophthalmology department in the period from October 1997 to January 1998. The age of patients ranged from 50-80 years. They were 16 females and 12 males. Preoperative examination included visual acuity testing, slit lamp examination, lOP measurement and fundus examination, gonioscopic examination and a gonio diagram was drawn for each one. The type of 10L used in all our patients was modified J-Ioop multipiece PC IOL with the haptic vaulted anteriorly 10 degrees. Our post operative sittings were at two weeks, one month, two months, three month and six month. In each sitting we specially comment on gonioscopic examination and lOP measurement and any other fmdings. In our gonioscopic examination either pre-or post-operatively we specially stressed on: 1- Grading of depth of the angle. 2- The pigmentation of the angle. 3- Peripheral anterior synechia (PAS). 4- Patches of iris atrophy. 5- Angle neovascularization. 6- Any other abnormalities. The results of our study revealed: Peripheral anterior synechiae formation in (43.3%) of our cases (20% at the site oflens haptics, 6.7% away from it and 16.6% at and away from the lens haptics), all PAS developed, were of the focal type not the broad one so, no cases of angle closure from PAS developed. The incidence of pigment dispersion in our study was (66.7%) and no cases developed pigmentary glaucoma. Patches of iris atrophy were observed in (36.7%) of eyes in our study and were all related to the site of lens haptics. Angle neovascularization was not observed in any of the eyes examined in this study. There was no significant increase in lOP in our study. The recommendation offered by this study: Follow up of cycs with posterior chamber IOLs by gonioscopy should be routine, together with lOP measurement , to detect any late changes after implantation. 1,ntrabagal fixation of IOL haptics is recommended to reduce the incidence of development of angle changes as it decrease the uveal touch by the sulcus fixated haptics. However, even with bag implantation there will remain only a very thin capsular membrane between the haptic loops and peripheral iris tissue, that, with the inherent elasticity of polymethylmethacrylate (PMMA), haptics might still easily displace the peripheral iris tissue anteriorly. |