Clinical Study of Secondary Intraocular Lens Implantation in Aphakic Patients

Abstract

Introduction: Secondary implantation of a lens is insertion of a lens in any eye rendered aphakic by trauma or prior surgery. The subject of secondary IOL implantation is and will remain extremely important in developing countries for many decades to come. The reason in that a great majority of cataract operations were being performed without primary intraocular lens implantation. The result is that a large number of aphakic subjects still seek remedy for their aphakic disability. To analyse the visual outcome & complications following implantation of secondary intraocular lens implantation in aphakic patients.Materials and methods: This is a hospital based prospective clinical study conducted at K.V.G Medical College and Hospital, (Sullia, D.K) during the period of November 2014-May 2016, which included 50 monocular aphakia patients who presented to our outpatient department. These patients were treated surgically with secondary intraocular lens implantation by either of the three procedures.18 pts with ACIOL implantation, 16 pts for ICIOL implantation and remaining 16 for SFIOL implantation. These patients were followed up for a period of 3months post operatively and BCVA with Snellen’s distance visual acuity chart was noted. Complications were also noted in the postoperative period.Results: BCVA (6/9 or more) was seen in 78% of all cases with 83.3% in ACIOL group,75% in SFIOL group and 75% in ICIOL group. Minor complications like striate keratopathy, corneal oedema and anterior uveitis was seen and subsided with treatment. Patient (8%) developed hyphema and increased IOP which resolved with treatment.2(4%) patient had persistent corneal oedema in spite of treatment 3 months post operatively and had BCVA of 6/24. 2(4%) patients developed cystoid macularedema for which topical corticosteroids plus NSAIDs like ketorolac 0.5% was given.2(4%) patients developed vitreous loss 1(2%) pt developed early decentration of intraocular lens for which immediate reposition of lens was done surgically and 3(6%)patients developed late decentration of lens thus reducing the visual acuity to 6/18. 3(6%) patients developed depigmentation of lens (ICIOL group) but it didn’t affect the visual acuity much.Conclusion: Secondary intraocular lens implantation is a safe and effective method of correcting aphakia and avoids the disadvantages associated with aphakic spectacles and contact lens ACIOL, ICIOL, SFIOL implantations have comparable results as per post operative visual acuity and complications are concerned and each is good in its own sense as per our study Hence, secondary intra ocular lens implantation is a good surgical option for patients with aphakia seeking to overcome their aphakic disability.