EXTRACAPSULAR CATARACT-SURGERY WITH AND WITHOUT INTRAOCULAR-LENS IMPLANTATION IN FUCHS HETEROCHROMIC CYCLITIS

Purpose: To compare the surgical and postoperative complications and v isual outcome of extracapsular cataract extraction (ECCE) with and wit hout intraocular lens (IOL) implant in Fuchs heterochromic cyclitis. M ethods: The records of 77 patients with Fuchs heterochromic cyclitis w ho had undergone ECCE were reviewed. Of a total of 77 eyes, a posterio r chamber IOL (PC IOL) was implanted in 43 eyes, whereas 34 eyes did n ot receive an implant. Results: In the pseudophakic group, 40 (93%) ey es achieved 20/40 or better. This level also was achieved in 29 (85%) eyes not receiving an implant. Intraoperative anterior chamber hemorrh age was documented in 18 eyes but there was no correlation with preope rative gonioscopic findings. A temporary or permanent elevation of int raocular pressure was noted in five of eight eyes that had marked ante rior chamber hemorrhage. Severe postoperative uveitis occurred in ten eyes and was more common in patients with glaucoma who had PC IOL impl antation, but this did not adversely affect the visual outcome. Of 40 eyes with PC IOL implant, severe postoperative uveitis developed in 7. In six of these seven eyes, the implant was a three-piece lens with p olypropylene haptics. Severe postoperative uveitis developed in 6 of 1 6 eyes with preoperative glaucoma. Five of these six eyes had a PC IOL implant. Of the 34 aphakic patients, 10 (29%) were intolerant of cont act lens correction. There was no difference in the incidence of posto perative uveitis, cystoid macular edema, and development of glaucoma b etween the two groups. Conclusion: Implantation of PC IOLs in ECCE in patients with Fuchs heterochromic cyclitis appears to a safe procedure , but careful postoperative follow-up of intraocular pressure, particu larly in patients with intraoperative hemorrhage or postoperative uvei tis, is indicated.