B. Wiechens et al., BILATERAL CATARACT AFTER PHAKIC POSTERIOR CHAMBER TOP HAT-STYLE SILICONE INTRAOCULAR-LENS, Journal of refractive surgery, 13(4), 1997, pp. 392-397
BACKGROUND: New strategies have been developed for surgical treatment
of high myopia. Recently, implantation of minus power posterior chambe
r intraocular lenses (IOL) into phakic eyes has been introduced. METHO
DS: We report a 31 year-old female patient who developed bilateral ant
erior subcapsular cataract 7 years after minus-power, top hat-style si
licone posterior chamber IOL implantation in Russia. The corrected vis
ual acuity was right eye 20/200 and left eye 20/63. Because of the hig
h myopia and the posterior chamber IOL in her phakic eyes, biometry fo
r IOL calculation gave contradictory results. Both posterior chamber I
OLs were found to be adherent to the crystalline lenses. after posteri
or chamber IOL explantation and phacoemulsification, intraoperative re
tinoscopy was performed. With this aphakic refraction, the IOL power w
as calculated and implanted. The explanted posterior chamber IOLs were
examined by scanning electron microscopy. RESULTS: After bilateral op
eration the corrected visual acuity increased to right eye 20/32 and l
eft eye 20/40, respectively. On scanning electron microscopy, a membra
nous structure of unknown origin was noted on the entire surface of th
e explanted posterior chamber IOLS. CONCLUSION: There is a potential r
isk of cataract formation after implantation of this top hat-style sil
icone posterior chamber IOL. If cataract extraction in this specific s
ituation is needed, a different approach for calculating the aphakic I
OL power is necessary, such as intraoperative retinoscopy.