Opaque intraocular lens for intractable diplopia-UK survey.
(Implant intraoculaire opaque contre la diplopie incoercible - une étude britannique)

Kwok T, Watts P.
University Hospital of Wales, Cardiff, UK.

AIMS: To assess the practice of the use of an opaque intraocular lens (IOL) for intractable diplopia in the UK.

METHODS: A questionnaire was sent to 892 consultant ophthalmologists in practice requesting information on the treatment of intractable diplopia with an opaque IOL. Respondents were asked whether they would consider using an opaque IOL for intractable diplopia. Information was gathered on the numbers of lenses implanted, the type of lens used, and whether the lens was implanted inside or outside the capsular bag. In addition, we asked for the causes of intractable diplopia, the success in eliminating diplopia, the use of postoperative pilocarpine, and whether postoperative surveillance was part of the follow-up protocol.

RESULTS: Of the 481 completed questionnaires received, 72% would consider implanting an opaque IOL. A total of 48 surgeons had implanted 1 or more lenses. There were 97 patients who were implanted with an opaque IOL over the past 15 years. Strabismus, nerve palsies, and previous retinal detachment surgery with diplopia were the main indications. Pseudophakic lenses were used by 38 surgeons in the capsular bag, 6 used iris-supported phakic lenses, and 2 used phakic lenses in the anterior chamber angle. The use of postoperative pilocarpine was reported by 9 surgeons, and 6 surgeons used regular ultrasound fundal surveillance. Patients were reported to be completely asymptomatic at discharge by 31 surgeons, with 15 surgeons reporting patients who were still symptomatic postoperatively. Only 1 intraoperative complication was reported.

CONCLUSIONS: An opaque IOL is a safe method for treating intractable diplopia. This survey confirms that its practice is widely accepted in the UK.

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