Ten-year results of anterior chamber fixation of the posterior chamber intraocular lens

Objective: To report the outcomes in eyes in which a Sinskey-type conventional posterior chamber intraocular lens (PC-IOL) was fixed in the anterior chamber and followed up for an average of 10 years. Methods: Twenty-one eyes were included in the study. The IOLs were conventional hard PC-IOLs, 13.0 mm in overall length with 6.0-mm polymethylmethacrylate optic and polyvinylidene fluoride loops that tilted 10degrees anteriorly. Results: At implantation the corneal endothelial cell density in 13 of 21 eyes was 382 to 1580 cells/mm(2) owing to the previous implantation of iris-clip or iridocapsular IOLs. The overall postoperative corneal endothelial cell loss was 30.9%. Six of 14 eyes with a preoperative corneal endothelial cell density less than 2000 cells/mm(2) developed bullous keratopathy. Although serious complications did not occur in 7 eyes with a cell density exceeding 2000 cells/mm(2), an average corneal endothelial cell loss of 26.5% still occurred. Except for 2 eyes, all loops were fixed at the scleral spur and a slight pupillary transformation occurred in only 1 eye. Conclusion: Although this procedure is easy to perform and pupillary transformation does not occur, it is not recommended for aphakic eyes owing to the high corneal endothelial cell loss after an average 10-year follow-up.