Journal of AdvancedMedical and Dental Sciences Research

Background: A successfully performed cataract extraction is the first step in the visual rehabilitation of a cataract patient. Thus aphakia is the first complication of cataract surgery that actually is the absence of the lens in the eye due to surgical removal, a perforating wound, ulcer or congenital anomaly. It causes loss of accommodation, hyperopia, deep anterior chamber and is associated with complications like detachment of the vitreous or retina and glaucoma. The present study was conducted with the aim to compare the visual outcome in subjects with Scleral Fixated Intra Ocular Lens (SFIOL) implantation and Anterior Chamber Intra Ocular Lens (ACIOL) implantation in aphakes and to compare intraocular pressure (IOP) and endothelial count (EC) amongst them. Materials and methods: The present study was conducted in the out-patient department of ophthalmology at INHS Asvini, Mumbai. A total of 40 aphakic eyes were included. The aphakic eyes were divided at the random into two groups - Group A and Group B with 20 patients in each group. Group A underwent SFIOL and Group B went ACIOL implantation respectively. Classic Ab Externo Technique for secondary Ciliary Sulcus SFIOL Fixation was performed to insert single piece Poly Methyl Methacrylate lens with eyelets and for secondary ACIOL implantation Single piece Poly Methyl Methacrylate flexible open loop ACIOL was used. Visual acuity, IOP and Endothelial Count were measured in all eyes at post-operative Day 1, Day 4, Day 15, Day 30 and Day 45. Subjects were also examined after 6 months and 12 months of surgery. All the data thus obtained was arranged in a tabulated form and analyzed using Student’s unpaired ‘t’ test. Probability value of less than 0.05 was considered as significant. Results: Visual acuity ( expressed in  log MAR) improved from 0.94 ± 0.11 to 0.44 ±  0.13 in group A and group B eyes showed improvement from 0.95 ± 0.11 to 0.24 ± 0.09. Preoperative mean IOP in SFIOL (17.2 ± 2.09 mmHg) increased by 13.95% to 19.6 ± 2.11 mm Hg after surgery. An increase of 21.08% was seen in preoperative IOP levels of 16.6 ± 2.98 mmHg to 20.1 ± 2.86 mmHg after ACIOL implantation. SFIOL implantation in group A lead to 5.42% fall in Endothelial Count as compared to ACIOL implantation that caused a fall of 11.66% in group B eyes. A statistically significant improvement was seen in visual acuity after ACIOL implantation as compared to SFIOL implantation. The comparison of post operative IOP levels of SFIOL and ACIOL revealed statistical significance. However there was no statistical difference in the endothelial count between the groups. Conclusion: We have reported higher rise in IOP after ACIOL implantation. Endothelial count decreased with both implantations but more so with ACIOL implantation. As SFIOL implantation is technically more difficult than ACIOL implantation, the decisive factor in choosing a secondary IOL is surgical experience.
Keywords: Cataract, implantation, Endothelial, Ocular.

Received: 18 February, 2019                           Revised: 28 March, 2019                               Accepted: 29 March, 2019

Corresponding author: Dr. Mandeep Kaur, Assistant Professor, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India

This article may be cited as: Kaur M, Mohindra V K. Comparison of visual outcome and complications between Scleral Fixated Intraocular Lens and Anterior Chamber Intraocular Lens in Aphakes.  J Adv Med Dent Scie Res 2019;7(5): 59-62.