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J. L. Ferreira, T. A. B. Souza, H. P. Guimarães-Neto; Rupture or Assimetry of Anterior Capsulorrhexis and Implant of Diffractive Intraocular Lens. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1152.
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© ARVO (1962-2015); The Authors (2016-present)
To verify if positioning of the haptics of diffractive intraocular lens (IOL) in the same meridian of ruptured (RC) or asymmetric (AC) capsulorhexis has any difference compared to the IOL centralization in continuous curvilinear capsulorhexis (CCC) cases following cataract surgery.
This is a comparative non randomized case series of 25 eyes of 16 patients submitted to cataract surgeries with diffractive IOL (ReSTOR®) implantation. Three groups where analyzed, considering the anterior capsulorhexis: ruptured capsulorhexis (RC) limited to the anterior capsule; asymmetric capsulorhexis (AC) and continuous curvilinear capsulorhexis (CCC). In all cases of AC and RC the IOL was implanted with its haptics in the same meridian of rupture or largest asymmetry of the capsulorhexis. Centralization of the IOL (X) was verified through digital anterior segment photography with Topcon® TRC50-DX IMAGEnet 2000® with dynamic and dilated pupils. To assess the centralization (X) of IOL, the formula A + B / C + D = X was used, where A + B and C + D are the measures of the center of the IOL to the largest and smallest distance to the edge of the pupil (dynamic pupils) and to the edge of the capsulorhexis (or to the edge pupil under mydriasis, when the capsulorhexis is extended under the iris).
Patients’ age ranged from 54 to 86 years, mean 71.5 years; 12 (75%) were female, 13 (52%) left eyes. All digital photographic documentation was taken after 90 days of surgery, ranging between 92 and 181 days. Of the 25 eyes, 8 (32%) were in RC, 2 (8%) were in AC and 15 (60%) were in CCC group. The calculation of centralization of the IOL under dynamic pupil ranged from 1 to 1.12 (average 1.04) in RC, from 1.05 to 1.12 (average 1.08) in AC and from 1 to 1.12 (average 1.05) in the CCC group. Under mydriasis it ranged from 1.14 a 1.62 (average 1.27) in the RC, from 1.10 to 1.29 (average 1.19) in the AC and from 1 to1.47 (average 1.12) in the CCC group.
Positioning of the haptics of IOL in the same meridian of ruptured (RC) or asymmetric (AC) capsulorhexis might be suitable for selected cases with technical flaws of cataract surgery.
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