Silicone plate-haptic posterior chamber intraocular lens implanted in the anterior chamber: report of a bilateral case and potential complications.

Background and objective: To evaluate possible complications associated with implantation of a posterior chamber (PC) intraocular lens (IOL) in the anterior chamber.

Materials and methods: We analyzed a plate-haptic silicone IOL that had been explanted from the anterior chamber of an 83-year-old female. Additionally, the lens was experimentally reimplanted into the anterior chambers of 3 human cadaver eyes. After fixation of the eyes (Karnovsky's solution), the anterior-posterior length, the white-to-white diameter, the angle-to-angle diameter, and the sulcus-to-sulcus diameter were measured. Two different techniques to cut the eyes were used: sagittal section and corneal buttonhole technique. The plate-haptic silicone lens was then implanted in the anterior chamber and sulcus ciliaris of the eyes. A Kelman multiflex IOL was used as a control for anterior chamber implantation.

Results: This experiment demonstrated that the plate-haptic silicone IOL lens is too small and thick for implantation in the anterior chamber and in the sulcus. The lens could easily rotate in the anterior chamber and also dislocate inferiorly, obstructing the visual axis by its edge. The thickness of the lens theoretically could also cause endothelial cell damage and mechanical iris irritation resulting in chronic uveal inflammation.

Conclusion: This case and experiment should help surgeons realize the risk and potential for IOL-missizing complications that may be caused if a lens design for the capsular bag is implanted in the anterior chamber, especially if a plate-haptic PC-IOL design is used.