Cataract operations on the remaining eye

Abstract

In the last five years, 500 one-eyed patients have undergone cataract surgery at the authors' hospital. A Simcoe-type posterior chamber lens was implanted in 425 of the eyes. An eye was defined as an only eye if corrected vision in the fellow eye was 1/60 or less, or better vision in cases of amblyopia. The main causes of loss of function in partner eyes were macular degeneration, amblyopia, and glaucoma. The rate of intraoperative and postoperative complications was the same as in the entire patient collective, and in absolute terms actually lower. There were four cases of intraoperative rupture of the posterior capsule (in two of which it subsequently proved possible to fit a posterior chamber intraocular lens (PCIOL], and one case each of corneal decompensation and excessive hemorrhage into the anterior chamber. PCIOLs were subsequently also implanted in both these eyes. Early postoperative complications included several cases of iris prolapse, all of which were easily rectified, and intermittent phases of endothelial decompensation associated with cornea guttata. In view of the low overall rate of intraoperative and postoperative complications, the authors advocate implantation of a PCIOL in remaining eyes with visual function, except those with proliferative retinopathies (primarily diabetes mellitus), pre-existing retinal detachments (particularly in young men with myopia and a history of detachment in the fellow eye), and unregulated glaucoma.