In-the-bag toric intraocular lens implantation in the case of an anterior capsule tear: a case series

Dervenis, Panagiotis; Dervenis, Nikolaos; Chiras, Dimitrios

doi:10.5935/0004-2749.20190088

ABSTRACT

Purpose:

To analyze the outcomes of in-the-bag toric intraocular lens implantation for anterior capsular tears during phacoemulsification.

Methods:

The cohort of this retrospective, consecutive, interventional case series included eight patients. One patient was excluded as the tear was used to enlarge the rhexis. The mean preoperative astigmatism was -1.67D (± 0.98) and the mean preoperative unaided logMAR visual acuity was 0.62 (± 0.76). The mean angle between the anterior capsule tear and the closest intraocular lens haptic was 51.25° (range, 30°-90°).

Results:

The final unaided logMAR visual acuity was 0.16 (± 0.21) and the final cylinder was -1.1 D (± 0.59). The mean follow-up duration was about 2 ± 1.2 months. In this case series, no lens had to be explanted or rotated postoperatively. Placement of a toric intraocular lens in the presence anterior capsule tear was safe in all patients. An angle of at least 30° remained between the tear and the intraocular lens haptic.

Conclusion:

Placement of toric intraocular lens in the presence of an anterior capsule tear may be safe, at least in cases with a 30° angle between the anterior capsule tear and the intraocular lens haptic.

Keywords:
Phacoemulsification/adverse effects; Cataract; Lens implantation, intraocular; Visual acuity

[1] Corresponding author: Nikolaos Dervenis. 9 St Aidans Road, Carlisle, CA1 1LT. E-mail:nikosdervenis@gmail.com

Variable
Sex
Male	n=3, 42.9%
Female	n=4, 57.1%
Age, mean (SD)	61.71 (11.29)
Preop Kmin, mean (SD)	42.24 (1.01)
Preop Kmax, mean (SD)	45.06 (1.65)
Preop sphere, mean (SD)	0.54 (4.05)
Preop cylinder, mean (SD)	-1.67 (0.98)
Preop logMAR visual acuity, mean (SD)	0.62 (0.76)
Axial length, mean (SD)	24.05 mm (1.8)

Variable
Toric IOL
SN6AT4	n=1 (14.3%)
SN6AT5	n=4 (57.2%)
SN6AT8	n=2 (28.6%)
Predicted postop spherical equivalent, mean (SD)	-0.18 (0.15 D)
Predicted postop cylinder, mean (SD)	0.18 D (0.16)
Degrees between ACT and IOL haptic, mean (SD) range	51.25 (26.6), 30º-90º

Variable	Mean (SD)
Three weeks unaided logMAR visual acuity	0.21 (0.20)
Three weeks best corrected logMAR visual acuity	0.07 (0.01)
Three weeks sphere	-0.29 (0.55)
Three weeks cylinder	-1.30 (0.75)
Final unaided logMAR visual acuity	0.16 (0.21)
Final best corrected logMAR visual acuity	0.05 (0.08)
Final sphere	-0.25 (0.56)
Final cylinder	-1.10 (0.59)
Follow-up in months	1.96 (1.19)

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