SECONDARY INTRAOCULAR-LENS IMPLANTATION - 8TH YEAR EXPERIENCE

Objective-To investigate the outcome of secondary intra-ocular lens implantation. Neither a requirement for vitreous surgery nor previous complicated eye surgery/trauma was considered necessarily to be a contra-indication. Design-Retrospective Study. Recruitment was achieved by examination of operating theatre records. Setting-Teaching Hospital. Patients-52 out of 54 consecutive cases in whom a secondary lens had been implanted from 1982-1989 under the care of one consultant (BAN). Interventions-The medical records of all patients were reviewed and data collected for 52 of the total of 54 patients. Main outcome measures-Visual acuity and major complications. Results-77% of eyes retained the same Snellen visual acuity or better than that pre-operatively and 88% were within one line or better. The Mann Whitney U-test showed that neither vitreous manipulation at the time of secondary lens implantation nor a previous history of trauma had a significant effect on the change between pre-and post-operative Snellen visual acuity. Only one patient developed a retinal detachment and eight had cystoid macula oedema although in only one patient did this account for a final decrease in post-operative visual acuity of more than one line. The most common complication was an intense post-operative uveitis (35%) leading in some cases to indefinite low dose topical steroid treatment (21%). Conclusions-This technique gives good visual results, even in the disorganised eye, providing the vitreous is adequately managed. However there is a significant complication rate which should be discussed with the patient before undertaking surgery.