PubMed · 15411303
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A COWAN. 1950. Aphakia.. https://pubmed.ncbi.nlm.nih.gov/15411303/
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BACKGROUND: The risk of glaucoma among aphakic children is as high as 32%, based primarily on intraocular pressure (IOP) measurements. Although IOP may be falsely elevated by increased central corneal thickness, central corneal thickness (CCT) values have not been reported in this population. METHODS: Patients from the practices of 2 pediatric ophthalmologists and 2 glaucoma specialists had measurements of CCT, IOP, and optic nerve cupping, with visual field analysis when possible. Normal fellow eyes of unilateral aphakes and pseudophakes were included as controls. RESULTS: In 36 aphakic and 6 pseudophakic eyes CCT averaged 660 microns compared with 576 microns for phakic fellow eyes (P < 0.0001). Glaucoma, defined by IOP at least 35 mm Hg or by IOP at least 22 mm Hg associated with optic nerve changes, occurred in 21% of 28 aphakic patients but in no pseudophakic patient. CONCLUSIONS: CCT in aphakic/pseudophakic children is substantially increased compared with control patients. These values may be important in interpreting IOP measurements in these children.
PURPOSE: To describe two cases of secondary congenital aphakia in association with Peters anomaly. METHODS: Two infants were noted to have corneal opacification at birth. Each child was found to have Peters anomaly requiring corneal transplantation in 1 or both eyes. RESULTS: Each child underwent penetrating keratoplasty, revealing absence of the crystalline lens in 1 eye. Histopathologic evaluation of the corneal buttons was performed. Each specimen showed full-thickness corneal defects with lens remnants. CONCLUSIONS: Secondary congenital aphakia from corneal perforation should be considered in the presentation of severe Peters anomaly.
The evolution of cataract surgery during the recent 2 centuries, and especially in the last 50 years, witnessed essential changes--from reclination of the lens and a traditional extracapsular cataract extraction to cataract microsurgery including phacoemulsification. A lack of the lens in the eye, i.e. aphakia, is considered to be a serious complication. The optic extraocular correction of aphakia is implemented mainly by the use of spectacles and contact lenses, which are not deprived of essential shortcomings. H. Ridley was the first to implant, in 1949, a polymethylmethacrylate (PMMA) intraocular lens (IOL). After that, anterior-chamber and iris-clips lenses as well as extrapupillary lenses with fixation to Sulcus cyliaris, which had by some complications, were offered. Only in 1973, we offered, for the first time in the world practice, an intracapsular implantation and intercapsular fixation of IOLs of various models. The designed intraocular correction of aphakia was checked by time and it is used now in cataract microsurgery, including small-incisions as well as ultrasound and laser phacoemulsification. The use of the lens bag as a natural bed for the fixation and isolation of IOL from intraocular structures is a priority direction in the Russian research ophthalmology.