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

Tian Tian,Chunli Chen,Peiquan Zhao,Qi Zhang,Lyu Jiao,Haiying Jin

doi:10.1186/s12886-018-0741-2

Tian Tian, Chunli Chen + Show 4 more

Open Access

https://doi.org/10.1186/s12886-018-0741-2

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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.

Highlights

To 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
The concept of our optic capture technique was derived from “the rhexis-fixed Lens” which was firstly described by Neuhann for placing the haptics in the sulcus and capturing the IOL optic through the anterior continuous curvilinear capsulorhexis (CCC) opening [6]
Successful optic capture IOL implantation was achieved in all 20 aphakic eyes (20 patients)

Summary

Introduction

To 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. The status of lens capsules may not be sufficient to support IOL intracapsular bag implantation, especially during secondary procedure Under these challenging and complicated situations, variously substituted IOL implanting techniques have been reported, including sulcus-IOL implantation, using an anterior chamber IOL, an iris-fixed IOL, and a transscleral-fixed posterior chamber IOL. Each of these techniques has postoperative problems and Compared to these substituted IOL implanting techniques mentioned above, our optic capture technique was a simple and safe choice in cases with intact residual capsular opening during the secondary IOL implantation. The concept of optic capture technique was firstly described by Gimbel and DeBroff to maintain a clear visual axis in pediatric IOL surgery with the haptics in the capsular bag and optic through a posterior

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