Suitability of the open loop lens Phacoflex XI-30 for capsular sick implantation by self-sealing sclerocorneal tunnel incisions

Abstract

We studied a new intraocular lens implant with a high-refractive silicone optic and prolene C-loops. Suitability for folding and implantation with the recommended instruments as well as its performance as a capsular bag implant were evaluated. The impact of the self-sealing wound construction used on postoperative corneal stability was also studied. We included 35 consecutively operated eyes. Capsulorhexis and phacoemulsification were performed. A well-centered and round 4-5 mm anterior capsular opening was aimed at. Using the Fine Universal or the Livernois-McDonald folder the optic was folded lengthwise and the leading loop tucked within the crease. The lens was implanted through a self-sealing sclerocorneal tunnel which measured 3.0 mm in length and 3.2 mm in width. With the instrumentation described, a 3.2 mm incision was adequate. - The lens centered well. In one case each decentration resulted from an optic-edge-by-rhexis-rim capture with an inappropriately shaped rhexis and from excessive capsular bag shrinkage with a too small rhexis. As a rule, the posterior capsule was distended and, with five exceptions, firmly attached to the optic. Fibrosis had resulted in only two cases where the rhexis had evaded the optic edge. Except for a single case where a filtering procedure had been simultaneously performed, optic-to-iris clearance was pronounced in all cases. Consequently, signs of iris chafing were never seen and iridocapsular synechiae had never formed in the latter. - Typically, fine granules scattered within the material and a bluish-violet tint were noted. However, neither intensive haze nor brownish discoloration as well as shell- or inner contour-phenomena were never present. - Vector analysis showed a negligible initial astigmatic shift against the wound that did not progress further on. This new implant performs very satisfactory. It may be even further improved by eliminating the granular inclusions and increasing the haptic rigidity. In order to prevent fibrotic opacification of the posterior capsule full circular overlap of the optic periphery by the anterior capsular leaf should be aimed at. The advantage of the reduced incision width required for insertion makes it very appropriate for clear corneal incision surgery.