Complications of sulcus placement of single-piece acrylic intraocular lenses: recommendations for backup IOL implantation following posterior capsule rupture

David F Chang; Samuel Masket; Kevin M Miller; Rosa Braga-Mele; Brian C Little; Nick Mamalis; Thomas A Oetting; Mark Packer; ASCRS Cataract Clinical Committee

doi:10.1016/j.jcrs.2009.04.027

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Journal article

Peer reviewed

Complications of sulcus placement of single-piece acrylic intraocular lenses: recommendations for backup IOL implantation following posterior capsule rupture

David F Chang, Samuel Masket, Kevin M Miller, Rosa Braga-Mele, Brian C Little, Nick Mamalis, Thomas A Oetting, Mark Packer and ASCRS Cataract Clinical Committee

Journal of cataract and refractive surgery, Vol.35(8), pp.1445-1458

08/2009

DOI: 10.1016/j.jcrs.2009.04.027

PMID: 19631134

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Abstract

To describe complications arising from sulcus placement of single-piece acrylic (SPA) intraocular lenses (IOLs), evaluate IOL options for eyes that lack adequate capsule support, and examine the appropriateness of various IOL designs for sulcus placement. University and private anterior segment surgery practices. Patients referred for complications of SPA IOLs in the ciliary sulcus from 2006 and 2008 were identified. Demographic information, examination findings, and complications of the initial surgery were recorded. Details of surgical interventions and the most recent corrected distance visual acuity (CDVA) were noted. A thorough review of the literature was undertaken to analyze options for IOL placement. Complications of sulcus SPA IOLs included pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage, and cystoid macular edema. Two patients in the series of 30 patients experienced 1 complication; 8 experienced 2 complications; 13 experienced 3 complications; 4 experienced 4 complications; and 2 experienced 5 complications. Twenty-eight eyes (93%) required surgical intervention; IOL exchange was performed in 25 (83%). Postoperatively, the mean CDVA improved, with most eyes attaining 20/20. Intraocular lenses designed solely for the capsular bag should not be placed in the ciliary sulcus. Backup IOLs in appropriate powers, sizes, and designs should be available for every cataract procedure. The development, investigation, and supply of IOLs specifically designed for placement in eyes that lack adequate capsule support represent clinically important endeavors for ophthalmology and the ophthalmic industry.

Humans

Middle Aged

Exfoliation Syndrome - etiology

Male

Lenses, Intraocular

Phacoemulsification

Prosthesis Design

Ciliary Body - surgery

Lens Implantation, Intraocular - adverse effects

Lens Capsule, Crystalline - pathology

Lens Capsule, Crystalline - surgery

Aged, 80 and over

Female

Lens Implantation, Intraocular - methods

Acrylic Resins

Aged

Postoperative Complications

Suture Techniques

Practice Guidelines as Topic

Details

Title: Subtitle: Complications of sulcus placement of single-piece acrylic intraocular lenses: recommendations for backup IOL implantation following posterior capsule rupture
Creators: David F Chang - Altos Eye Physicians, Los Altos, California 94024, USA. dceye@earthlink.net
Samuel Masket
Kevin M Miller
Rosa Braga-Mele
Brian C Little
Nick Mamalis
Thomas A Oetting
Mark Packer
ASCRS Cataract Clinical Committee
Resource Type: Journal article
Publication Details: Journal of cataract and refractive surgery, Vol.35(8), pp.1445-1458
DOI: 10.1016/j.jcrs.2009.04.027
PMID: 19631134
NLM abbreviation: J Cataract Refract Surg
ISSN: 0886-3350
eISSN: 1873-4502
Publisher: United States
Language: English
Date published: 08/2009
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983979927002771

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