Long-term results of the Binkhorst iris clip lens in senile cataract.

The purpose of this paper is to consider the long-term results of the iris clip lens in senile aphakia. It is not intended to discuss the many different forms of intraocular lens implants. Ophthalmic surgeons are well aware of the discouraging shortand long-term failure rate when contact lenses are used to correct aphakia, and this has stimulated renewed interest in intraocular lens implants in both Europe and America. Bonnet, Massin, and Gerhard (I966), reviewing 308 adult unilateral aphakics, found that after IO years only 20 per cent. were still wearing their contact lens. Mills and Lewis (197I), reviewing I32 patients who had been fitted with scleral contact lenses between I961 and I966 inclusive, found at the end of I968 that 46 per cent. were no longer wearing their contact lenses, although nine had worn the contact lens successfully before cataract extraction on the second eye. Despite this, the authors concluded that the insertion of the intraocular lens as a primary procedure is not indicated in patients, who, at the time of preoperative assessment, seem suitable for contact lens fitting. Martin Walker (1968), in a 5-year survey of 74 patients for whom contact lenses were authorized, found that only 3 I were still wearing their contact lens at the time of the review. It is difficult to convince a unilaterally aphakic patient, who has good vision in his phakic eye and is unable to tolerate a contact lens, that the operation that he has undergone is a success, even if he has useful visual function in the aphakic eye. The Figure shows the iris clip lens in position.