Abstract

Gonioscopy and goniophotography were performed on 137 eyes with the Optiflex angle supported implant. At the time of gonioscopy the lenses had been in situ for a median of 20 months, with a range of 3-38 months. In 75.9% of cases one or both haptics were positioned posterior to the scleral spur with some degree of iris push. Iris tuck was seen in 29.2% of cases. Three different types of fibrous tissue formations were seen in the angles. The first two types (sleeving and iris haptic adhesions) occurred in the majority of cases and were haptic related. The third type was in the form of true peripheral anterior synechiae and occurred in 17.5% of cases. In cases with haptic related adhesions only, the angle remained open. Secondary glaucoma developed in 12 cases (8.7%). Ten cases had open angles. In the remaining two cases peripheral anterior synechiae were present in more than two-thirds of the angle, which was considered to be closed. Total burial of one of the haptics occurred in 25.5% of cases. A prominent iris vessel was observed near one of the haptics in nine cases. The thin looped haptics appear to stimulate fibrous tissue formation in the majority of cases. The haptic related adhesions add to the stability of the implant. It would make dislocation of the lens unlikely, even under severe trauma to the eye. However, once formed it would make removing the implant virtually impossible without severing the haptics. With time and with burial, the haptics seem to move away from the direction of the cornea. Total insulation of the haptic from the peripheral cornea is achieved with the occurrence of total burial.