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Informal allusions to the widespread use of two-looped semiflexible anterior chamber lens implants as "back-up" lenses in patients originally selected for posterior chamber implantation led the authors to do a retrospective study of complicated cases in their practice during a two-year period. While there may be some surgeons who simply abort implantation in the case of loss of posterior capsule integrity, vitreous loss or vitreous instrumentation, there seems to be a trend for extracapsular surgeons to substitute an anterior chamber lens under these conditions. During the study period, no planned lens implantation procedure was aborted. The postoperative complications and visual results of those eyes in which anterior chamber lenses were substituted are the subject of this presentation. As expected, the results in patients with a surgical complication are worse than in uncomplicated cases, but the visual reduction is nominal. The prognosis if capsule disruption occurs without vitreous complication is excellent.

Placement of posterior chamber lens implants in the capsular bag is facilitated if the capsular fornix is maintained by Healon. The distal loop slides easily into the bag and the proximal loop can be dropped behind the elevated anterior capsule flap. This technique achieves a high degree of success with respect to good implant lens position. Use of this method avoids decentration and pupillary capture associated with placing only one loop in the capsular bag.