Capture of intraocular lens optic by residual capsular opening in secondary implantation: long-term follow-up

Abstract

BackgroundTo introduce a novel surgical technique for optic capture by residual capsular opening in secondary intraocular lens (IOL) implantation and to report the outcomes of a long follow-up.MethodsTwenty patients (20 eyes) who had received secondary IOL implantation with the optic capture technique were retrospectively reviewed. We used the residual capsular opening for capturing the optic and inserted the haptics in the sulcus during surgery. Baseline clinical characteristics and surgical outcomes, including best-corrected visual acuity (BCVA), refractive status, and IOL position were recorded. The postoperative location and stability of IOL were evaluated using the ultrasound biomicroscopy.ResultsOptic capture technique was successfully performed in all cases, including 5 cases with large area of posterior capsular opacity, 6 cases with posterior capsular tear or rupture,and 9 cases with adhesive capsules. BCVA improved from 0.60 logMAR at baseline to 0.36 logMAR at the last follow-up (P < 0.001). Spherical equivalent changed from 10.67 ± 4.59 D at baseline to 0.12 ± 1.35 D at 6 months postoperatively (P < 0.001). Centered IOLs were observed in all cases and remained captured through residual capsular opening in 19 (95%) eyes at the last follow-up. In one case, the captured optic of IOL slid into ciliary sulcus at 7 months postoperatively. No other postoperative complications were observed in any cases.ConclusionsThis optic capture technique by using residual capsule opening is an efficacious and safe technique and can achieve IOL stability in the long follow-up.

Surgical management of aphakia

“…46 Optic capture has not been shown to significantly affect endothelial cell count. 47 Reverse optic capture, which describes the placement of IOL haptics in the bag with the IOL optic brought forward through the anterior rhexis has been shown to be effective, even with single-piece acrylic IOL with no vision-threatening complications reported over a mean follow-up of 19 months. 48 Reverse optic capture is indicated for negative dysphotopsia, prevention of toric IOL rotation, and salvage use of a single-piece IOL, which has been implanted in an eye where a posterior capsule rupture is subsequently encountered.…”

Intraocular Lens Elongation Technique with Haptic Modification for Sulcus Implantation

“…However, in the absence of anterior capsular support, sulcus implantation is known to be contraindicated, and in such cases, anterior chamber intraocular lens (IOL) implantation, iris fixation, or scleral fixation may be preferred based on the features of the eye. 1 , 2 …”

“…However, in the absence of anterior capsular support, sulcus implantation is known to be contraindicated, and in such cases, anterior chamber intraocular lens (IOL) implantation, iris fixation, or scleral fixation may be preferred based on the features of the eye. 1,2 One-piece acrylic IOLs, which are manufactured for intracapsular placement, are poor choices for sulcus implantation. Their overall length is small for the ciliary sulcus, and their optics have no posterior angulation.…”