Complications of Semiflexible, Closed-Loop Anterior Chamber Intraocular Lenses

Anterior chamber intraocular lenses (IOLs) provided good visual rehabilitation of aphakia in a majority of patients. An increasing number of eyes with closed-loop, semiflexible anterior chamber implants are now being seen with decreased vision due to corneal edema and persistent cystoid macular edema. We evaluated 53 such eyes in 52 patients who presented with decreased vision one to 51 months (average, 15 months) after lens implantation. The most frequent lens implanted was the Surgidev Style 10 Leiske IOL. Surgery for IOL removal or exchange with or without penetrating keratoplasty was performed in 34 (64%) of 53 eyes; visual acuity recovery ranged from 20/20 to hand motions (average, 20/80). Despite clear corneal grafts in 24 (92%) of the 26 eyes that underwent corneal transplantation, visual acuity of 20/40 or better was obtained in only nine eyes (26%). Based on the intractable inflammatory sequelae associated with anterior chamber closed-loop IOLs, we strongly urge discontinuation of their use.