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Posterior capsular tears not an obstacle to in-the-bag IOL fixation, study finds
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ALBERTA, Canada — In-the-bag fixation of IOLs can be achieved in most eyes despite posterior capsular tears, according to a retrospective study here. With an intact continuous curvilinear capsulorrhexis and with conversion of the posterior capsular tear to a posterior continuous curvilinear capsulorrhexis, complications were minimized in this series of patients.
Researchers at the Gimbel Eye Center identified 83 eyes in which posterior capsular (PC) tears occurred over an 8-year period. The surgical technique used included continuous curvilinear capsulorrhexis (CCC), nucleofractis phaco and IOL implantation. Different intraoperative surgical strategies such as posterior CCC were used in the management of PC tears.
Forty-nine percent of the 83 eyes received vitrectomies. In 51 of the 83 eyes (61.4%), the PC tears were able to be converted to posterior CCC. Of those 51, 50 had PC IOL in-the-bag fixation. The other eye had posterior CCC with optic capture. None of the eyes required pars plana vitrectomy.
Seventeen eyes had Neuhann anterior capsule rhexis fixation with the haptics placed in the sulcus and the IOL securely in the bag. Ten eyes had the IOL placed in the sulcus, and five eyes required anterior chamber IOL fixation.
None of the PC tear eyes resulted in clinically evident cystoid macular edema, retinal detachment or endophthalmitis.
The study is published in the December issue of Ophthalmology.