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Proper IOL selection needed after posterior capsule rupture
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WAIKOLOA, Hawaii — The size and location of a posterior capsule rupture help determine what type of IOL should be used, according to a speaker here.
“What are our considerations? We have a [posterior capsule] tear, so where is it and how big is it? Will an anterior vitrectomy be required, and where can I place or fixate my lens? Is there sulcus support, and do I have enough anterior capsule?” Marjan Farid, MD, said at Hawaiian Eye 2019.
A one-piece IOL is suitable for an in-the-bag placement if the tear is small and circular. To increase stability, Farid said a toric lens with reverse optic capture can be considered.
A larger tear requires a three-piece IOL, possibly placed in the sulcus if anterior capsular support is evident. If there is minimal to no capsular support, a three-piece IOL can be fixated to the iris or sclera, Farid said.
“In the cases where the posterior capsule is in bad shape and there is a lot of zonular dehiscence, this is a case where we would have to fixate the lens to either the iris or the sclera,” she said. – by Robert Linnehan
Reference:
Farid M. IOL selection following PC rupture. Presented at: Hawaiian Eye; Jan. 19-25, 2019; Waikoloa, Hawaii.
Disclosure: Farid reports no relevant financial disclosures.