Pinching and detachment of the intraocular lens haptics during implantation

Abstract

Background. Modern small incision surgery involves the use of injection systems for implanting intraocular lenses (IOLs) into a capsule bag. As with any other stage of cataract phacoemulsification, there are also risks of complications during implantation, consisting in damage to IOLs of varying severity from microcracks of optics to detachment of haptic lens elements. There is no convincing data on the effect of micro-destruction of the optical part of the IOL on the functional results of lens surgery, however, damage to the lens support elements affects the effective position of the IOL, which leads to visual defects (glare, flare) and the inability to achieve calculated refraction. Pinching and/or detachment of the IOL haptics during implantation is a rare situation that every ophthalmic surgeon can encounter. At the same time, there are isolated works on this topic in the literature that do not describe ways to prevent and resolve this complication.The aim. To demonstrate, using clinical examples, surgical tactics for pinching and tearing of haptics of intraocular lenses during implantation. Material and methods. Clinical cases are presented using the example of patients with pinching and detachment of IOL haptics during implantation.Results. The presented clinical cases reflect the features of surgery for damage to the supporting elements of the intraocular lens.Conclusion. Pinching of haptic elements in the injector during implantation surgery can be resolved by simple dissection of the cartridge with a keratome knife. In the case of a haptic detachment, the use of the method of rear “capture” of IOL optics in the presence of a haptic stump of sufficient size (1 mm or more) allows the lens to be securely fixed in the central position.