Effect of number and position of intraocular lens haptics on anterior capsule contraction: a randomized, prospective trial

Abstract

BackgroundThe present study aimed to evaluate the degree of anterior capsule contraction (capsulorhexis contraction) with three different single-piece, hydrophilic acrylic intraocular lenses (IOLs).MethodsPatients were prospectively randomized to be implanted with one of three types of IOLs during cataract surgery: the Ophtec Precizon (IOL A), the Lucid Korea Microflex (IOL B), and the Carl Zeiss Asphina (IOL C). One week, 2 weeks, and 6 months after surgery, the area of the anterior capsule opening was measured using digital retro-illumination images after dilation of the pupil. The data were then evaluated using POCOman software.ResultsThe study included 236 eyes of 202 patients. The area of the anterior capsule opening reduced by 3.53 ± 3.31 mm (17.06% ± 15.99%) between 1 week and 2 months post-operatively in the IOL A group, by 0.62 ± 1.32 mm (2.87% ± 6.03%) in the IOL B group, and by 1.09 ± 1.53 mm (4.72% ± 6.10%) in the IOL C group. The IOL B group showed minimal anterior capsule contraction 2 months after surgery (p < 0.001).ConclusionsIOLs with a four-plate haptic design (IOL B) showed more anterior capsular stability than those with a two-loop plate haptic (IOL A) or two-plate haptic (IOL C) design. The number and position of haptics in a capsular bag may affect anterior capsule contraction. We assume that supporting the zonules evenly may play a role in anterior capsular stability.Trial registrationCurrent Controlled Trials ISRCTN76566080, Retrospectively registered (Date of registration: 14 Feb 2018).

Changes to the Anterior Capsular Opening of Human Lens after Cataract Surgery in Patients with Subluxated Lenses. Summary of the Doctoral Thesis

“…Kim et al reported a contraction in the anterior capsule of 18.60-18.99 mm 2 on average during surgery to 16.81-17.75 mm 2 in the 3month observation period for cataract surgery patients who had an intraocular lens implanted, similar to the ones used in the current study. Overall, the average reduction in the capsulorrhexis field formed 6.76-10.87 % of the size of the initial capsulorrhexis in eyes without pathology (Kim et al, 2013), and similar tendencies in eyes without pathology corresponded to the observations made by Choi et al (Choi et al, 2018) and Corydon et al (Corydon et al, 2007). Whereas, as reported by Kato, contraction of the capsulorrhexis in a 9-month period, reduces by 14 % on average in eyes without pathology (Satoshi Kato et al, 2002).…”

“…The average capsulorrhexis area for research patients was 14.24 mm 2 during surgery, which is markedly smaller than the usual capsulorrhexis area created during an uncomplicated cataract operation, which is usually 5-5.5 mm (Choi et al, 2018;Hayashi et al, 2011;Hayashi & Hayashi, 2005;Kim et al, 2013) in diameter, corresponding to 19.625-23.75 mm 2 area. A small capsulorrhexis area for research patients can be explained by 2 factors -pronounced lens mobility due to weakened or non-existing zonules Vasavada et al, 2012b) and the surgical technique used in which the iris or capsular hooks (retractors) are attached to the capsulorrhexis (and consequently, the entire lens) edge.…”

Anterior Capsule Opening Contraction and Late Intraocular Lens Dislocation after Cataract Surgery in Patients with Weak or Partially Absent Zonular Support

“…The average capsulorrhexis area for research patients was 14.3 mm 2 during surgery, which is markedly smaller than the usual capsulorrhexis area created during an uncomplicated cataract operation, which is usually 5–5.5 mm [ 32 , 33 , 34 , 35 ] in diameter, corresponding to a 19.625–23.75 mm 2 area. A small capsulorrhexis area for research patients can be explained by two factors—pronounced lens mobility due to weakened or non-existing zonules [ 28 , 31 ] and the surgical technique used in which the iris or capsular hooks (retractors) are attached to the capsulorrhexis (and consequently, the entire lens) edge.…”

“…The surgeries were performed with phacoemulsification and IOL implantation in the capsular bag. Small initial capsulorhexis (anterior capsule openings), if compared to other published data [ 32 , 33 , 34 , 35 ], were created due to the weak zonules.…”

Effect of anterior capsule polish on visual function: A meta-analysis

“…[27] In addition, the IOL haptic design and material were reported to have effects on LECs proliferation and capsule contraction. [28,29] Both the implantation and location of IOL played important roles in anterior capsule stability and migration of LECs. After lens removed, the remnant LECs on the capsular bag underwent proliferation and transdifferentiation, resulting in capsule opacification.…”