Light and scanning electron microscopy of rabbit lens capsules with intraocular lenses

PURPOSE: To examine postoperative changes in the lens capsules of rabbit eyes after phacoemulsification and aspiration of the crystalline lens and implantation of posterior chamber intraocular lenses (IOLs) using light and scanning electron microscopy. SETTING: Research Laboratory, Department of Ophthalmology, Wakayama Medical College, Japan. METHODS: The crystalline lens was emulsified and aspirated and an IOL implanted in the capsular bag or ciliary sulcus of each eye in adult albino rabbits under general anesthesia. Animals were killed after 4 weeks, and the lens capsules were removed. The specimens were observed under phase-contrast microscopy and processed for light and scanning electron microscopy. RESULTS: Phase-contrast microscopy revealed presumed lens epithelial cells (LECs) on the central posterior capsules in association with regenerating lenticular fibers and Elschnig pearls in the peripheral capsules. Scanning electron microscopy showed the accumulation of fibrous extracellular matrix on the surface of the posterior capsule in eyes in which the IOL was implanted in the ciliary sulcus. Deposition of packed material attached to the surface of IOLs and of Soemmering's ring were observed in eyes with in-the-bag IOL fixation. At a higher magnification, a parallel arrangement of lenticular fibers was seen in the regenerated lens structure on posterior capsules. An identical structure was observed under light microscopy. Outgrowth of presumed LECs from residual anterior lens capsules and adhesion of macrophages and giant cells were observed on the IOL surface. CONCLUSION: Two types of postoperative changes were observed in lens capsules after implantation of IOLs: accumulation of fibrous extracellular matrix and newly formed lenticular fibers. These changes are attributed to the proliferation of LECs and can induce posterior capsule opacification after IOL implantation.     

Is the implantation of a second intraocular lens prior to the removal of the first implants remaining in the vitreous cavity incorrect medical treatment?

BACKGROUND: The implantation of an intraocular lens into the capsular bag is a common procedure in modern cataract surgery. In case of a break of the posterior capsule it is possible to implant the intraocular lens by rhexis-, ciliary sulcus- or pars-plana-fixation. The following case is in so far remarkable, as a second intraocular lens has been implanted while a dislocated intraocular lens was still in the vitreous cavity. PATIENT: We report on a 70-year-old patient who underwent cataract surgery. After a break in the posterior capsule the intraocular lens dislocated into the vitreous cavity. A second intraocular lens has been implanted in the ciliary sulcus. 41 days after cataract surgery the dislocated intraocular lens has been removed by pars-plana-vitrectomy without any problems. CONCLUSION: Intraocular lens implantation in the ciliary sulcus is not proved to be a hindrance with regard to the transcleral removal of a posteriorly dislocated intraocular lens, following the principles of intraocular foreign body surgery.     

Secondary intraocular lens implantation after cataract surgery in children

PURPOSE: To report results of secondary intraocular lens implantation after cataract surgery in children. METHODS: We reviewed clinical records for a 5-year period of patients who had cataract surgery in childhood and received a secondary intraocular lens implant. We studied indications for secondary intraocular lens placement; surgical procedures for intraocular lens implantation; preoperative and postoperative visual acuity, refractive error, and binocular status; and complications of the procedure. RESULTS: A secondary intraocular lens was placed in 28 eyes of 25 patients who had cataract surgery in childhood. In 20 eyes, the lenses were placed in the ciliary sulcus. The other eight eyes had insufficient capsular support for an intraocular lens; in two, the intraocular lens was placed in the anterior chamber and, in six, in the posterior chamber with suture fixation to the sclera. Twenty of 28 eyes (71%) had measurable improvement in visual acuity; only one eye had a decrease in visual acuity of 2 lines. Fifteen patients (54%) had a final refraction within 1.50 diopters of the fellow eye; 21 (75%) were within 3.00 diopters. During follow-up, two eyes developed glaucoma. One had transient pressure elevation; one required two filtration procedures. Three patients required Nd:YAG capsulotomy. Six patients demonstrated Worth fusion at distance and near; three demonstrated 200 seconds of arc or better stereo visual acuity. CONCLUSION: Secondary placement of an intraocular lens in the posterior chamber appears to be a safe, effective alternative for correction of aphakia in the contact lens- or spectacles-intolerant child or young adult.     

Long-term results of implantation of a plate haptic silicone lens in the capsular sac

BACKGROUND: An important step in developing cataract surgery was the introduction of soft foldable silicone intraocular lenses in the middle 80's. Functional and morphological long-term data are a vital base for definite conclusions on the new material's safety and biocompatibility. PATIENTS AND METHODS: Our study presents the long-term results after the implantation of a silicone posterior chamber lens with solid plate haptic design (STAAR AA-4203). All lenses were folded and implanted through a 4-mm small corneoscleral incision. Our study includes 54 eyes in 52 patients with a mean follow-up period of 56.5 +/- 8.9 months. RESULTS: A visual acuity of 20/40 or better was found in 90.7% of all eyes. All except one of the 33 eyes without any further preexisting ocular pathology at the time of the operation achieved a visual acuity of 20/40 or better. Two thirds of all eyes had a horizontal astigmatism of +1.0 D or less. By slitlamp examination more or less dispersed pigment was seen on the IOL's surface in 46.3%. 83% of the silicone lenses were centrated within 0.5 mm. A YAG-laser capsulotomy was performed in 7 cases (13%). IOL-related intraocular inflammations, cystoid macular edema or an elevated intraocular pressure did not occur in this group. CONCLUSIONS: Our satisfactory long-term results suggest an excellent biocompatibility of the IOL's design and material.     

Menadione induces changes in the membrane electrical properties associated with downregulation of insulin receptors in human erythrocytes

BACKGROUND AND OBJECTIVE: To investigate the course of the intraocular pressure (IOP) in nonglaucomatous patients with pseudoexfoliation (PSX) syndrome after cataract surgery. PATIENTS AND METHODS: In a prospective age-matched controlled clinical study, 23 consecutive patients with PSX were studied and compared with a control group of 23 patients. The IOP was measured by applanation tonometry preoperatively, and postoperatively on day 1, after 4 weeks, and after 6 months. All patients were operated on with a self-sealing 7-mm scleral tunnel incision, phacoemulsification, and posterior chamber intraocular lens (IOL) implantation. RESULTS: Preoperatively the IOP was similar between both groups (P = .962). At the first postoperative day the IOP was below 22 mm Hg in all cases. After 4 weeks and 6 months a mean decrease of 3.88 mm Hg (P = .001) in the control group and of 3.15 mm Hg (P = .002) in the PSX group was observed; this difference was not statistically significant (P = .543). CONCLUSIONS: At 1 day postoperatively no pressure increase was observed in the eyes with PSX after scleral tunnel incision and phacoemulsification. Six months after cataract extraction with IOL implantation, the tension level decreased in the presence of PSX similarly as in normal eyes.     

Perineural invasion of the lower alveolar nerve by oral cancer: a follow-up study of 12 cases

The authors studied the intraocular pressure (IOP) changes after phacoemulsification with two different kinds of foldable silicone lens implantation using Healon GV as viscoelastic substance. One hundred patients undergoing cataract surgery were enrolled in this study. Inclusion criteria were: absence of ocular hypertension or glaucoma. Patients were randomly assigned to plate haptic (Silens PH, Domilens Chiron Vision, Lyon, France) or three-piece (CeeOntrade mark& ;920, Pharmacia spa, Milano, Italia) silicone intraocular lens (IOL) implantation. Following phacoemulsification and cortical aspiration, the capsular bag was reinflated with Healon GV. After foldable silicone IOL insertion residual Healon GV was removed from the anterior chamber. IOP was measured preoperatively and at 6, 24 h and 1 week postoperatively. Six hours postoperatively IOP was higher in the Silens PH group than in the CeeOn group (20. 85+/-5.42 vs. 18.88+/-2.95 mm Hg, p= 0.026). The difference was confirmed after 24 h (21.02+/-5.18 vs. 17.34+/-3.18 mm Hg, p < 0.01). Despite the medical treatment (acetazolamide 250 mg orally every 6 h), at the 24-hour control 2 eyes with plate haptic silicone lens showed IOP values higher than 30 mm Hg. Slitlamp examination showed in both eyes a shallowing of the anterior chamber together with the evidence of capsular bag hyperdistension and capsular block resulting from the occlusion of the circular anterior capsule opening by the plate haptic IOL. Residual Healon GV removal from the anterior chamber was performed. At 1-week control both eyes showed normalization of IOP. The use of a plate haptic silicone lens may be associated with a more consistent retention of Healon GV in the eye with trapping in the capsular bag. Retained viscoelastic may cause either trabecular meshwork blockage by viscoelastic substance or postoperative capsular bag hyperdistension, anteroplacement of the IOL optic and capsular block from occlusion of the circular anterior opening by the IOL optic.     

Extracapsular cataract extraction with posterior chamber lens implantation in primary angle-closure glaucoma

PURPOSE: To evaluate long-term intraocular pressure (IOP) control after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (IOL) implantation in patients with primary angle-closure glaucoma. SETTING: Ophthalmology Department, Groote Schuur Hospital, Cape Town, South Africa. METHODS: This retrospective study comprised 17 patients (19 eyes) with primary angle-closure glaucoma who had ECCE and posterior chamber IOL implantation. Four presented initially with acute glaucoma, 5 with subacute angle-closure glaucoma, and 8 (10 eyes) with chronic angle-closure glaucoma. In all, less than half the circumference of the angle was permanently closed. The drainage angle was evaluated preoperatively and postoperatively to monitor changes in the amount of angle closure. Intraocular pressure was measured in the early and late postoperative periods. RESULTS: On the first postoperative day, mean IOP was 17.2 mm Hg, although 5 patients (26%) had an IOP rise above 21 mm Hg despite the use of perioperative topical pilocarpine gel. After a mean follow-up of 19 months, IOP remained below 22 mm Hg without medication in 13 eyes (68%) and with topical medication in 5 eyes (26%). Mean number of glaucoma medications was reduced from 1.5/eye preoperatively to 0.5/eye postoperatively. CONCLUSION: Cataract extraction with IOL implantation resulted in good long-term IOP control in patients with primary angle-closure glaucoma, suggesting that combined cataract and trabeculectomy surgery may not be necessary to achieve long-term IOP control in these patients.     

Experimental study and clinical application of arterialized venous skin flap

BACKGROUND: A new IOL implantation technique introduced in Germany since December 1995 is presented--the one-piece-plate-haptic silicone lens implantable with the Passport system. METHOD: From January to September 1996 in 291 patients after 3.2 mm clear cornea incision, capsulorhexis, phacoemulsification and implantation of an one-piece silicone posterior chamber lens with an implantation system was performed. The early post-operative results like visual outcome, astigmatism and complication rate are presented and compared to a group of 100 patients with implanted foldable three-piece silicone posterior chamber lenses. RESULTS AND DISCUSSION: The first post-operative day no statistically significant differences in visual outcome (mean: one-piece 0.71; three-piece 0.69), in absolute astigmatism (mean diopter 0.82 one-piece; 0.91 three-piece), in axial position and in complication rate were detectable. Differences of this new implantation technique compared to the conventional technique are discussed. CONCLUSION: The implantation of one-piece silicone lenses with the Passport system is a reliable and high quality alternative to conventional systems.     

Reduced intraocular pressure after phacoemulsification and posterior chamber intraocular lens implantation

PURPOSE: To ascertain whether phacoemulsification with posterior chamber intraocular lens (IOL) implantation causes long-term reduction in intraocular pressure (IOP). SETTING: Private practice, Kempten, Germany. METHODS: Intraocular pressure was measured in both eyes of 120 consecutive patients who were unilaterally phakic after phacoemulsification a mean of 17 months +/- 17 (SD) previously. Mean age of the 36 men and 84 women was 76 +/- 10 years. Data were analyzed using binomial distribution and the Wilcoxon signed-rank test. RESULTS: The median ratio of IOP in the pseudophakic eye to IOP in the phakic eye was 0.83. The IOP was lower in the pseudophakic eye in 96 patients (80%). The median IOP was 12 mm Hg in the pseudophakic eyes and 14 mm Hg in the phakic eyes (P < .001). As measured by the interquartile range, IOP distribution was more centered in the pseudophakic than in the phakic eyes (3 versus 4). The IOP in the pseudophakic eyes remained lower to the last measurement, 5 years postoperatively, and appeared to be independent of patient age. Lower IOP in the pseudophakic eye was consistently present in patients with higher IOP in the phakic eye (16 to 22 mm Hg). CONCLUSION: Phacoemulsification with posterior chamber IOL implantation reduced IOP in most but not all patients with a preoperative IOP of 22 mm Hg or less. This reduction was maintained over several years, with the cause yet to be established. Lower IOP may decrease the risk of subsequent glaucomatous nerve damage in these patients.     

Early central posterior capsular fibrosis in sulcus-fixated biconvex intraocular lenses

A series of 228 eyes implanted with one-piece all poly(methyl methacrylate) (PMMA) biconvex posterior chamber intraocular lenses was examined for posterior capsule opacification. One hundred forty-one eyes (61.8%) had opacification at an average postoperative period of 19.7 months. Seventy eyes (30.7%) developed an unusual form of early central posterior capsular fibrosis (ECPCF), which was confined to the capsulorhexis opening, sparing the peripheral aspect of the anterior and posterior capsules. Risk factors for developing this form of opacification were close apposition of peripheral anterior and posterior capsules caused by placing a posteriorly vaulted biconvex optic anterior to a capsulorhexis opening smaller than the optic diameter. This opacification occurred most often in cases of haptic fixation in the ciliary sulcus. The cumulative capsulotomy rate in this series was 5.26% at three months, 9.1% at 12 months, and 13.2% at 20 months. Of the ECPCF cases, 34.3% eventually required neodymium: YAG (Nd:YAG) laser capsulotomy; the capsulotomy rate for ECPCF was 4.8 times higher than that for Elschnig pearls. Early onset of ECPCF (average onset = 19.4 weeks) resulted in early Nd:YAG capsulotomy (average = 8.0 months after surgery). One-piece all-PMMA biconvex intraocular lenses may promote early central fibrosis of the posterior capsule if the lens optic is anterior to a capsulorhexis opening smaller than the optic diameter. The early onset of this form of opacification predisposes to earlier Nd:YAG capsulotomy with a higher risk of complications.     

Changes in anterior chamber depth and intraocular pressure after phacoemulsification and posterior chamber intraocular lens implantation

BACKGROUND AND OBJECTIVE: To determine anterior chamber depth (ACD) and intraocular pressure (IOP) following uncomplicated cataract extraction with phacoemulsification and posterior chamber intraocular lens (IOL) implantation. PATIENTS AND METHODS: The ACDs and IOPs of 56 patients were prospectively evaluated after phacoemulsification and IOL implantation. Measurements of ACD were performed using ultrasonography and measurements of IOP were performed using a Goldmann applanation tonometer preoperatively and at 1 week and 1, 3, 6, and 9 months postoperatively. RESULTS: The mean IOP had decreased and the mean ACD had increased significantly by 1 month postoperatively (P < .03 and P < .01, respectively). Between 1 and 3 months, a significant increase in ACD (P < .05) and decrease in IOP (P < .01) was also observed. The ACD peaked (3.51 +/- 0.45 mm) and the IOP reached its lowest value (10.05 +/- 2.23 mm Hg) at 3 months postoperatively. The reduction in IOP and increase in ACD remained significant during the follow-up period, compared with the preoperative values. CONCLUSION: These results suggest that increases in ACD and decreases in IOP occur in selected patients after uncomplicated cataract extraction by phacoemulsification with IOL implantation.     

Topical plus subconjunctival anesthesia for phacotrabeculectomy: one year follow-up

PURPOSE: To evaluate the results of topical plus subconjunctival anesthesia for phacotrabeculectomy surgery and postoperative glaucoma control over 1 year. SETTING: Pacific Eye Center, Brisbane, Australia. METHODS: In this retrospective study of consecutive patients with glaucoma and cataract, topical plus subconjunctival anesthesia was used for combined phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy (phacotrabeculectomy). Patients with proliferative diabetic retinopathy or neovascular glaucoma were excluded. RESULTS: Thirty-eight eyes had phacotrabeculectomy using topical plus subconjunctival anesthesia over 2 years. Patients reported no discomfort intraoperatively or postoperatively, and none required intravenous sedation. Eighty-one percent of patients achieved a best corrected visual acuity of 20/40 or better 6 months after surgery. Mean drop in intraocular pressure (IOP) was 5.91 mm Hg at 3 months and 5.86 mm Hg at 12 months, at which time IOP was controlled without additional medication in 72% of patients. There were no serious complications postoperatively. CONCLUSION: In this series, no patient reported intraoperative or postoperative discomfort and surgical results were excellent in terms of visual outcome and IOP control.     

Effect of 3.0 mm tunnel and 6.0 mm corneoscleral incisions on the blood-aqueous barrier

PURPOSE: To study of the effect of silicone intraocular lens (IOL) implantation using a 3.0 mm tunnel incision with that of implantation though a 6.0 mm corneoscleral incision after phacoemulsification in human eyes. SETTING: Department of Ophthalmology, University of K?ln, Germany. METHODS: In a prospective, randomized clinical study, 50 patients with senile cataract had phacoemulsification and IOL implantation through a 3.0 mm tunnel or a 6.0 mm corneoscleral incision. To assess blood-aqueous barrier (BAB) disruption, preoperative and postoperative sodium fluorescein concentrations in the anterior chamber were measured with the Fluorotron Master II. Diclofenac sodium 0.1% was applied to the operative eyes five times a day for 5 days. The contralateral eyes served as controls. RESULTS: There was no significant between-group difference in sodium fluorescein concentrations in the 5 days after surgery. CONCLUSION: The findings underline our clinical impression that BAB disruption 5 days after surgery does not differ significantly with the type and length of scleral incision used for IOL implantation.     

Transscleral ciliary sulcus fixation of a posterior chamber lens in an eye with congenital aniridia

A 30-year-old man with bilateral congenital aniridia presented with a subluxated cataract in the right eye. He wore a soft contact lens for aphakic correction in the fellow eye after lensectomy for a subluxated cataract. We performed pars plana lensectomy and vitrectomy with implantation of a transscleral ciliary sulcus fixated posterior chamber intraocular lens in the right eye. Good postoperative visual acuity was obtained.     

Secondary implantation of scleral-fixated intraocular lenses

PURPOSE: To evaluate the results of a large series of secondary implantations using scleral-fixated posterior chamber intraocular lenses (IOLs). SETTING: Bellevue Eye Hospital, Kiel, Germany. METHODS: This retrospective review comprised 624 consecutive patients who had secondary implantation of a posterior chamber IOL with scleral fixation between 1988 and 1995. All patients had been aphakic for at least 1 year. An ab interno or ab externo suture technique through the ciliary sulcus was used. Visual outcome and complications 1 year after surgery were determined. RESULTS: Best corrected visual acuity improved or remained unchanged in 92.0% of eyes; 8.0% lost one or two lines. Intraocular lens decentration of more than 1.5 mm occurred in 1.9% of eyes. Suture erosion was observed in 17.9%, cystoid macular edema in 5.8%, retinal detachment in 1.4%, and vitreous hemorrhage in 1.0%. Severe uveitis occurred in 0.5%. CONCLUSION: Secondary IOL implantation with scleral fixation was a safe procedure. Although there was a small risk of significant complications, more than 90% of patients regained or improved their preoperative visual acuity.     

Posterior chamber intraocular lens use in children

PURPOSE: The authors report on the efficacy of intraocular lens implantation during pediatric cataract surgery and the results of a consecutive series of intraocular lens implantation in children. METHODS: Twenty-one children underwent implantation of intraocular lenses in 23 eyes. Twenty-one surgeries were primary implantation immediately following anterior lensectomy. Two surgeries were secondary implantations. Primary posterior capsulectomy was performed in 18 of 21 primary implantations. All but two eyes underwent a primary anterior vitrectomy. Topical prednisolone acetate was administered in all cases. Oral prednisone was administered in 17 of 23 cases. Pre- and postoperative visual acuity, cycloplegic refraction, and postoperative complications related to inflammation such as intraocular lens (IOL) capture, IOL decentration, and posterior capsule opacification were examined. RESULTS: Eighteen of 23 eyes have achieved a visual acuity of 20/40 or better. None of the cases in which oral prednisone was used developed complications related to postoperative inflammation. One of the six cases (17%) in which oral prednisone was not used developed such complications. CONCLUSION: Intracular lens implantation accompanied by primary posterior capsulectomy, anterior vitrectomy, and management of postoperative inflammation appears to provide appropriate and safe optical rehabilitation in children.     

Evaluation of the first 100 consecutive PhacoFlex silicone lenses implanted in the bag through a self-sealing tunnel incision using the Prodigy inserter

We evaluated the performance of the PhacoFlex silicone lens with open polypropylene loops and the disposable Prodigy inserter in a series of 100 consecutive no-stitch cases. Loading the lens into the PRO-1A inserter model was easy, as was inserting it through a 4 x 4 mm self-sealing sclerocorneal tunnel incision. If the chamber was deep and the capsular fornix expanded, unfolding the polypropylene loops was safe and direct bag placement was always possible. If the capsular bag was insufficiently distended, however, the posterior loop tended to entangle with wrinkles in the posterior capsule, jeopardizing the capsule's integrity. With a round and well-centered 4 mm to 5 mm capsulorhexis, centration was good provided the lens was completely within the bag. Even with proper bag placement of the haptics, however, the optic occasionally decentered slightly and tilted because of secondary capture in the capsulorhexis opening. With an incomplete capsulorhexis or a jagged-edged capsulotomy, malpositioning was not uncommon. This was due to secondary displacement of one haptic into the sulcus or partial capture of the optic by the anterior capsule leaf. Because of the flexibility of the polypropylene loops, the lenses tended to decenter and tilt following capsular shrinkage.     

Bone disease after liver transplantation should not be underestimated

PURPOSE: To report the management and outcome of cataract surgery and intraocular lens placement in a child with unilateral posterior lenticonus. METHODS: Case report. A 7-year-old boy with a best-corrected visual acuity of RE, 20/200, posterior lenticonus, and cataract underwent a pars plana lensectomy, vitrectomy, posterior chamber intraocular lens insertion into the ciliary sulcus, and central anterior capsulotomy. RESULT: At 2 years of follow-up, best-corrected visual acuity was RE, 20/40. CONCLUSION: This technique allowed complete removal of the opaque posterior lenticonus plaque while preserving the peripheral anterior capsule for sulcus fixation of the posterior chamber intraocular lens.     

Evaluation of a 3-piece silicone intraocular lens with poly(methyl methacrylate) haptics

PURPOSE: To evaluate the safety and performance of a foldable silicone intraocular lens (IOL) in small incision phacoemulsification surgery. SETTING: Vaasa Central Hospital, Vaasa, Finland. METHODS: Phacoemulsification with primary implantation of a posterior chamber IOL was performed in 50 patients. All eyes were implanted with a CeeOn IOL (model 920, Pharmacia & Upjohn) with a silicone optic and poly(methyl methacrylate) haptics. The ease of folding, implanting, and unfolding the IOL in the bag were recorded. Visual acuity, postoperative complications, optic decentration, and optic tilt were measured at 5 postoperative visits. The IOLs were evaluated for haze and discoloration and the IOL surface, for inflammatory or pigment deposits. Follow-up was 12 months. RESULTS: In 44 of 50 cases, folding the IOL was easy, and in 46 of 50, unfolding the IOL was controlled. The mean follow-up was 11.45 months +/- 0.52 (SD). No postoperative complications occurred, and 96% of patients achieved a best corrected visual acuity (BCVA) of 0.5 or better and 56%, a BCVA of 1.0 or better. The IOL decentration was less than 0.25 mm in 89% of cases, and there was no optic tilt. The neodymium:YAG laser capsulotomy rate was 11%. CONCLUSION: Good visual outcome and excellent centration were achieved with the CeeOn model 920 IOL. It is therefore suitable for small incision cataract surgery. Because of the IOL's smooth, polished surface, the choice of instruments for folding and implantation is important.     

Secondary intraocular lens implantation in children

OBJECTIVE: The study was designed to determine the visual outcome and indication of secondary posterior chamber intraocular lens (IOL) implantation. METHODS: The operation was performed on 34 eyes with aphakia in children after separation of posterior iris synechia from posterior capsule and formation of a posterior chamber space large enough to insert an intraocular lens. Based on whether the integrity of the posterior capsule was complete or not, various techniques of secondary IOL implantation were adopted. RESULTS: The follow-up periods ranged from 6 to 24 months. The results showed that 29 of the eyes (85.29%) achieved a post-operative corrected visual acuity equal to or better than that of the best corrected visual acuity before the surgery; the postoperative uncorrected visual acuities in 16 eyes (47.06%) and corrected visual acuities in 28 eyes (82.35%) reached 0.5 or better. CONCLUSION: Secondary posterior chamber IOL implantation is a safe and effective method in children who have a complete or partial posterior capsule.