Federov iris-supported intraocular acrylic lens.

The use of intraocular lenses in the correction of aphakia was first described by H. Ridley (I 951), and subsequently numerous designs have been described and their use enthusiastically recommended. The problems ofspectacle correction for aphakia are well known and have been described in detail (Editorial, I952; Linksz, I965), and many ophthalmic surgeons are only too familiar with the patient with unilateral aphakia and partial lens opacities in the other eye who cannot understand the surgeon's satisfaction, since the vision is blurred in one eye, and distorted in the other, and fusion is quite impossible because of aniseikonia. The use of contact lenses is usually recommended, but Pearce (1972) has recorded that in three separate series of patients fitted with contact lenses over 50 per cent. had abandoned their wear after some time. The optical advantages of an intraocular lens for all patients with aphakia are obvious, but particularly so in cases of uniocular aphakia. Nevertheless their use is not widespread because of the possibility of serious postoperative complications. This report describes a series of patients in whom Federov-type iris-supported intraocular acrylic lenses were implanted as a primary procedure at the time of extraction, with particular attention to the postoperative complications. The iris-supported method of fixation was chosen because of the advantages of a onestage procedure, and because of favourable long-term reports from several sources (Binkhorst and Leonard, I967; Dallas, I970; Federov, I965); the pattern designed by Federov was used because the arrangement of the fixation loops seemed easier to insert and the lens less likely to dislocate subsequently (Fig. i, opposite).*