Aphakia Correction With A Customised Anterior Chamber Lens - Case Presentations

Confronted with various cases of aphakia the need of a contemporary, simple, safe and effective optical

rehabilitation is overdue. Since the 1980s, there has been a lack of substantial advancements in anterior chamber lenses

(AC-IOL). The only available choice is a rigid PMMA lens (Kelman Multiflex 2, Alcon Fort Worth, USA) that has to be

inserted through a 5.0 mm corneal incision. A novel, tailor-made AC-IOL for addressing aphakia based on three

illustrative case reports is presented.

Case reports from a private eye clinic

Cases reported are: 1. congenital cataract and unilateral aphakia, 2. aphakia resulting from complicated

cataract surgery, and 3. aphakia due to late luxation of IOL-capsular-bag-complex. The AC-IOL (Type 37F Morcher GmbH

Germany, Design by Kermani) tailored for all cases is made of hydrophilic acrylate with three symetrical spiral haptics and a total

diameter of 13.0 mm. The spherical optic measures 5.0 mm in diameter. The three haptics are angled backwords at 10°

to enhance aqueous humor flow, and no iridectomy is necessary. The new AC-IOL is foldable and can be inserted with a

conventional shooter through a 2,2mm perilimbal incision. A "one-size-fits-all" approach is taken. All surgeries were

performed under topical anaesthesia.

Subsequent examinations at 1 day, 1 week, 3 months, and 12 months revealed

irritation-free conditions with well-centered AC-IOL. In all cases, best-corrected visual acuity of 0.1 LogMar or better was

achieved at the 12-month follow-up (within ±1.0 diopters of target spherical equivalent). Intraocular pressure remained

within the normal range (12-21 mmHg). The endothelial cell count was stable over the entire follow-up period of 12

months.

The presented AC-IOL (Morcher Type 37F, design by Kermani) offers a promising solution

for addressing aphakia stemming from various causes. The procedure is straightforward, effective, safe and if necessary

reversible. However, clinical trials are required to establish sustained tolerability.