Morphological changes 2 1/2 years after extracapsular cataract extraction with implantation of a posterior chamber lens

Morphological changes and lens position were examined in 51 eyes of 51 patients 25 to 37 (mean 31) months after extracapsular cataract extraction with implantation of a posterior chamber lens in the ciliary sulcus. Ocular morphology was compared to a previously published examination of the same eyes performed 4 months after surgery. The anterior chamber depth, lens position and the position of the posterior lens capsule had remained unchanged. 'Iris bulging', i.e. a gonioscopically visible slight impression of the iris overlying the lens haptics, had increased from 0 to 42%, iridal transillumination defects from 34 to 46%, and pigment dispersion in the chamber angle from 46 to 72%. Twenty-four percent of the eyes had developed significant, capsulotomy-requiring opacification of the posterior lens capsule. We draw the following conclusions: The posterior chamber lens and the posterior lens capsule have reached their permanent positions by the fourth post-operative month. Implantation of a posterior chamber lens in the ciliary sulcus constitutes a constant stimulus for structural changes of the iris with subsequent dispersion of pigment on neighbouring ocular structures.