Anterior capsule contraction and intraocular lens dislocation after implant surgery in eyes with retinitis pigmentosa

Abstract

Objective The purpose of the study was to investigate the extent of anterior capsule contraction, intraocular lens (IOL) decentration, and tilt after implant surgery in eyes with retinitis pigmentosa (RP). Design A case-control study. Participants Forty-seven eyes from 47 patients with typical RP and 47 control eyes from 47 age-matched healthy patients were studied. Intervention Phacoemulsification surgery with polymethylmethacrylate IOL implantation with continuous curvilinear capsulorrhexis was performed. Main outcome measures The area of the anterior capsule opening obtained with capsulorrhexis and the amount of the decentration and tilt of the IOL were measured using a Scheimpflug photography system at 1 week and 1, 3, 6, 9, and 12 months after surgery. Results The mean area in the RP group was found to be significantly smaller than that in the control group at 1 month after surgery and later ( P < 0.0001). The percent area reduction in the RP group at 6 months was 45.2 ± 25.8% and 4.6 ± 13.5% in the control group. Both the decentration length and tilt angle were also greater in the RP group than in the control group. Fourteen (29.8%) of the 47 RP eyes had undergone a neodymium:YAG (Nd:YAG) laser anterior capsulotomy at 12 months after surgery, whereas none of the control eyes had undergone an Nd:YAG. Conclusions Anterior capsule contraction in the RP eyes was more extensive than in the control eyes, leading to a high Nd:YAG laser anterior capsulotomy rate. Both lens decentration and tilt also were greater in the RP eyes than in the control eyes.