Abstract
Purpose :
Unintended sulcus placement of intraocular lens (IOL) haptics following cataract surgery can lead to severe glaucoma secondary to hemorrhage or inflammation from iris chafing. The occurrence of posterior capsular opacification (PCO), which is the most common complication of cataract surgery, is less well studied in these cases. This study aims to assess the prevalence of sulcus haptics and their potential association with PCO.
Methods :
A total of 429 post-mortem human eyes with IOLs, obtained from the Minnesota Eye Bank, were used in this cross-sectional cohort study at the MUHC-McGill University Ocular Pathology & Translational Research Laboratory. Each eye was assessed for sulcus placed IOL haptics using digital images, and PCO, as well as Soemmering’s Ring (SR) density, were quantified using Automated Detector Opacification Software (ADOS) as a factor of intensity and area. Two-tailed T-test was used to assess the mean difference in PCO and SR between eyes with sulcus haptics and controls. SR distribution pattern was also assessed and qualified as either focal, diffuse or absent. Odds ratios were calculated to determine if some patterns were more prevalent in each group.
Results :
Nineteen (4.4%) eyes contained IOLs with sulcus haptics. PCO was significantly more present in eyes with sulcus haptics (0.910 vs 0.680; mean difference 0.229, 95% CI 0.069-0.390, p = 0.019). Similarly, SR was also more present (13.751 vs 8.287; mean difference 5.464, 95% CI 2.336-8.592, p < 0.001). When compared to eyes with both haptics in the capsule, eyes with sulcus haptics were more likely to have focal SR opacity (OR 11.98, 95% CI 4.09-35.06) and far less likely to have diffuse opacity (OR 0.049, 95% CI 0.006-0.371).
Conclusions :
The prevalence of IOLs with haptics placed in the sulcus was significant in this study. Moreover, the occurrence of PCO and SR is more common in these eyes, with a more distinct pattern of opacification when compared with in bag haptics IOL. Given the significant ocular morbidity associated with sulcus haptics, this study offers signs suggesting their occurrence which may prompt earlier appropriate intervention.
This is a 2021 ARVO Annual Meeting abstract.