SECURITY OF CAPSULAR FIXATION - SMALL-VERSUS LARGE-HOLE PLATE-HAPTIC LENSES

Purpose: To assess the effect of relatively large positioning holes on the security of capsular bag fixation of plate-haptic silicone intrao cular lenses (IOLs). Setting: Center for Research on Ocular Therapeuti cs and Biodevices, Department of Ophthalmology, Storm Eye Institute, M edical University of South Carolina, Charleston, South Carolina, USA. Methods: This study tested the hypothesis that larger holes allow ingr owth of lens material, fibrous tissue, or both through them, which hel ps fixate the lens more firmly in the capsular bag. Five rabbits had b ilateral continuous curvilinear capsulorhexis, phacoemulsification, an d implantation of a plate-haptic silicone IOL. An IOL with a small, ro und positioning hole (Staar AA-4203V) was implanted in the right eye i n each rabbit, and a large-hole IOL (Staar AA-4203VF) was implanted in the left eye. After 2 months, all rabbits were killed. The force requ ired to extract one haptic from the capsular bag was measured with a d igital force meter. All eyes had histopathological analysis. Results: It was slightly more difficult to extract a large-hole IOL from the ca psular bag, although this trend was not statistically significant. How ever, histopathological analysis consistently showed 360 degree synech ia formation through the holes, showing that the IOL could be securely fixed in position. Conclusions: Proliferation of lens epithelial cell s through a large positioning hole in a plate-haptic silicone IOL may improve the long-term security of capsular bag fixation. This will hel p reduce the incidence of IOL decentration and dislocation.