EVALUATION OF THE 1ST 100 CONSECUTIVE PHACOFLEX SILICONE LENSES IMPLANTED IN THE BAG THROUGH A SELF-SEALING TUNNEL INCISION USING THE PRODIGY INSERTER

We evaluated the performance of the PhacoFlex silicone lens with open polypropylene loops and the disposable Prodigy inserter in a series of 100 consecutive no-stitch cases. Loading the lens into the PRO-1A ins erter model was easy, as was inserting it through a 4 x 4 mm self-seal ing sclerocorneal tunnel incision. If the chamber was deep and the cap sular fornix expanded, unfolding the polypropylene loops was safe and direct bag placement was always possible. If the capsular bag was insu fficiently distended, however, the posterior loop tended to entangle w ith wrinkles in the posterior capsule, jeopardizing the capsule's inte grity. With a round and well-centered 4 mm to 5 mm capsulorhexis, cent ration was good provided the lens was completely within the bag. Even with proper bag placement of the haptics, however, the optic occasiona lly decentered slightly and tilted because of secondary capture in the capsulorhexis opening. With an incomplete capsulorhexis or a jagged-e dged capsulotomy, malpositioning was not uncommon. This was due to sec ondary displacement of one haptic into the sulcus or partial capture o f the optic by the anterior capsule leaf. Because of the flexibility o f the polypropylene loops, the lenses tended to decenter and tilt foll owing capsular shrinkage.