Primary polypseudophakia for cataract surgery in hypermetropic eyes: refractive results and long term stability of the implants within the capsular bag

Aim-To determine the long term visual and refractive results, and stability and complications of primary polypseudo-phakia using poly(methylmethacryla te) (PMMA) intraocular lenses (IOLs) for cataract surgery in hypermetropic eyes. Methods-Prospective study of 15 short or hypermetropic eyes undergoing phac oemulsification with primary polypseudo-phakia with two PMMA IOLs implanted within the capsular bag. Results-The spherical equivalent was reduced from a mean +4.87 (SD 3.00) di optres (D) to -0.12 (1.40 D), and the deviation from the intended refractio n was +0.005 (1.30) D, 23.6 (12.36) months post-implantation. The deviation from intended refraction was not statistically significant (p = 0.989; pai red t test). Postoperative best corrected visual acuity (BCVA) was 6/12 or better in all eyes without macular or optic nerve co-morbidity. Interlentic ular opacification (ILO) in the form of peripheral Elschnig pearls was seen in four (26.67%) eyes. A new type of ILO in the form of usually pigmented deposits in the central interface developed in five (33.33%) eyes and resul ted in the appearance of Newton's rings in three. None of the eyes with ILO had any loss of BCVA or hyperopic shift. Six (40%) eyes were within I D fr om the intended refraction and 14 (93.33%) within 2 D. There was no statist ically significant difference in the accuracy of the two intraocular lens c alculation formulas used (SRK II and SRK/T). Conclusion-Peripheral Elschnig pearl-type ILO can occur as a late complicat ion of primary in the bag implantation of two PMMA IOLs. A new type of ILO is described. Both types of ILO have not to date resulted in deterioration of visual acuity in our cohort. Use of appropriate biometry techniques and IOL calculation formulas may yield more accurate refractive results.