Long-term follow-up of primary anterior chamber intraocular lens implantation

Purpose: To evaluate the long-term outcome in eyes having primary anterior chamber intraocular lens (AC IOL) implantation. Setting: Kimura Eye and Internal Medicine Hospital, Hiroshima, Japan. Methods: Primary AC IOL implantation was performed in in 171 eyes from 1983 to 1988. Two lenses were implanted: the open C-loop Simcoe lens and the 4-point fixation Kelman lens. In 86 eyes that had a mean follow-up of 9 years 7 months, visual acuity, corneal endothelial cell density, pupil shape, and the presence of associated complications were examined. Results: Although the final visual acuity was 0.5 or better in 60 eyes (69%), corneal endothelial cell density was less than 2000 cells/mm(2) in 46 eyes (57%). Postoperative, complications included a deformed pupil in 48 eyes (56%) and bullous keratopathy 12 eyes (14%). In 14 eyes the AC IOL was explanted; 11 of these were the open C-loop Simcoe lens. Conclusion: Although our findings show that the open C-loop AC IOL (Simcoe) is contraindicated, implantation of the 4-point fixation AC IOL may be acceptable in selected cases.