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Anterior chamber lens can be replaced with glued IOL in complicated eyes
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For the past 2 decades, anterior chamber IOLs have been an established method of IOL implantation in eyes with deficient capsules either as a primary or secondary procedure. Anterior chamber IOLs are preferred over sulcus-sutured IOLs because they are technically easier to implant, are reasonably well-tolerated, and have a low rate of postoperative IOL decentration or tilt. However, anterior chamber IOLs have also become one of the causes of IOL exchange and explantation.
Implant-related problems such as discrepancies between anterior chamber biometry and IOL size may cause pseudophakodonesis in the aqueous, resulting in progressive endothelial cell loss. Infrequently, anterior chamber IOL-iris contact may lead to pigment dispersion with subsequent inflammation. Occasionally, secondary angle closure and glaucoma with corneal decompensation due to haptic displacement may develop. Due to these reasons, eyes with shallow anterior chambers or early corneal guttata have been treated as relative contraindications for anterior chamber IOLs. The main advantage of a glued IOL in these cases is its anatomical position similar to the normal lens with no suture-related complications.
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