Four haptic vintage intraocular lens in anterior chamber: A story spanning decades

Amrita Joshi; Sanjay K Mishra; Alok Sati; Deepesh Unni

doi:10.4103/ijo.IJO_3100_21

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Year : 2022 | Volume : 2 | Issue : 3 | Page : 814-815

Four haptic vintage intraocular lens in anterior chamber: A story spanning decades

Amrita Joshi¹, Sanjay K Mishra¹, Alok Sati², Deepesh Unni¹
¹ Department of Ophthalmology, Army Hospital (Research and Referral), New Delhi, India
² Department of Ophthalmology, Cornea and Anterior Segment Services, Army Hospital (Research and Referral), New Delhi, India

Date of Submission	14-Dec-2021
Date of Acceptance	09-Feb-2022
Date of Web Publication	16-Jul-2022

Correspondence Address:
Dr. Alok Sati
Professor and Senior Advisor, Cornea and Anterior Segment Services, Department of Ophthalmology, Army Hospital (Research and Referral), New Delhi-01
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_3100_21

Abstract

Keywords: Disputed ACIOL, five-piece ACIOL, vintage ACIOL

How to cite this article:
Joshi A, Mishra SK, Sati A, Unni D. Four haptic vintage intraocular lens in anterior chamber: A story spanning decades. Indian J Ophthalmol Case Rep 2022;2:814-5

How to cite this URL:
Joshi A, Mishra SK, Sati A, Unni D. Four haptic vintage intraocular lens in anterior chamber: A story spanning decades. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Aug 14];2:814-5. Available from: https://www.ijoreports.in/text.asp?2022/2/3/814/351175

Herein, we present a case of a 70-year-old female who presented to our clinic for routine eye test. On examination, the best corrected visual acuity right eye (RE)-20/60, left eye (LE)-20/40, intraocular pressure by applanation tonometry RE-18 mm Hg, LE-16 mm Hg, slit lamp examination RE revealed clear cornea, normal anterior chamber depth with a four-point fixation, and five-piece flexible AC-IOL placed over the iris [Figure 1]. Iris chaffing present at 7 to 12 clock hours and peripheral iridotomy at 11 and 12 clock hours. Specular microscopy (Tomey ED 4000) showed a central corneal thickness of 511 microns, average endothelial cell count of 1647 cells/mm², hexagonality-33, and coefficient of variation-42 [Figure 2]. The most intriguing finding was the absence of any corneal endothelial decompensation which is invariably reported in patients with such disputed implants.

Figure 1: Five-piece IOL in the anterior chamber with iris chaffing from 7 to 12 o'clock along with peripheral iridotomy at 11 and 12 o'clock position. Clear cornea with no evidence of decompensation as shown by an arrow depicting the optic along with four haptics of ACIOL

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Figure 2: showing the specular microscpy findings of the patient

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Discussion

Ridley and Choyce contributed enormously to the development of an acceptable ACIOL. While iris-supported IOLs underwent major modifications in the 1960s through the early 1980s, several new designs of AC-IOLs were also introduced.^[1],[2],[3] However, by late 1970s, several others in the United States produced defective copies of the Choyce design. These ACIOLs gave the modern designs such ignominious reputation. However, these IOLs that emerged in late 1970s to mid-1980s were removed from most markets in the developed world.

Unfortunately, many such egregious designs were shipped overseas for use in the developing countries. We encountered one such rare infamous AC-IOL on routine examination at our center.

Conclusion

This sighting of such historic IOL is not usually reported in eye clinics across the country and advocates the preeminence of a superior surgical technique above all.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understand that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1.	Brown CA. Anterior chamber implants with the Ridley tripod lens. Proc R Soc Med 1976;69:908–11.
2.	Girard LJ, Hofmann RF, Pearlman PM. Expansile loops for anterior chamber lens implants. Ophthalmic Surg 1982;13:380–2.
3.	Lieb WA, Guerry D III. Anterior chamber lenses for refractive correction of unilateral aphakia. Am J Ophthalmol1957;44:579–98.