A 32-year follow-up of the rigid Schreck anterior chamber lens. A clinicopathological correlation

V. Rummelt, G. K. Lang, M. Yanoff and G. O. Naumann
Department of Ophthalmology, University of Erlangen-Nuernberg, West Germany.

We describe the clinicopathological findings in an eye after 32 years of successful anterior chamber lens implantation. In 1956, a rigid Schreck total polymethylmethacrylate anterior chamber lens was implanted in the right eye of a 28-year-old white man 1 year after corneo-scleral laceration with traumatic cataract. The postoperative clinical course was subjectively unremarkable for at least 30 years. In 1988, the patient developed secondary angle closure glaucoma, associated with a cavernous Schnabel optic atrophy that was caused by peripheral anterior synechiae and fibrovascular downgrowth into the anterior chamber. The lens implant was encapsulated "cocoonlike." Secondary proliferation of corneal endothelial cells covered the fibrous membrane and the chamber angle structures. No inflammatory reaction and only a very slight foreign-body reaction in the area of the footplate of the anterior chamber lens were present. Clinical and histopathological findings indicate that polymethylmethacrylate is sufficiently inert and biocompatible to be tolerated by the surrounding ocular tissues for more than 30 years.