Posterior Chamber IOLs Inside or Outside the Capsular Bag: A Cytopathologic Comparison of Two Eyes in One Patient

We compare the intraocular reaction to posterior chamber lens implants placed inside, with the reaction to implants placed outside the capsular bag during uncomplicated cataract extraction. Two otherwise normal eyes were obtained postmortem from a 93-year-old woman with clinically successful posterior chamber lens implants--one mostly in and the other outside of the capsular bag. While all parts of one implant in the bag were found to be free of reactive elements on their surface, the other whole implant and the one haptic outside of the bag were covered by a well-developed reactive membrane composed of a proteinaceous film with sessile macrophages and a few giant cells. Despite these remarkably different surface reactions, both eyes showed about equal pathologic evidence of associated chronic uveitus.