PHACOEMULSIFICATION AND LENS IMPLANTATION IN RABBIT EYES - CAPSULAR BAG VERSUS CILIARY SULCUS IMPLANTATION AND 4.0 VERSUS 7.0 MM CAPSULORHEXIS

Purpose: To compare the effects of intraocular lens (IOL) implantation in the capsular bag versus the ciliary sulcus and of a 4.0 versus 7.0 mm continuous curvilinear capsulorhexis (CCC) on postoperative inflam mation and after-cataract formation. Setting: St. Erik's Eye Hospital, Karolinska Institute, Stockholm, Sweden. Methods: Trial 1 comprised 4 0 rabbits that had CCC, endocapsular phacoemulsification, and a poly(m ethyl methacrylate) IOL implanted in the capsular bag in one eye and t he ciliary sulcus in the fellow eye. In Trial 2, 40 rabbits had a 4.0 mm CCC in one eye and a 7.0 mm CCC in the fellow eye followed by phaco emulsification and IOL implantation in the capsular bag. White blood c ell (WBC) counts and prostaglandin E-2 (PGE(2)) concentrations in aque ous humor were determined at 1, 3, 7(8), 28, and 56 days postoperative ly. Wet mass of the dissected after-cataract was measured at day 56. I n Trial 1, wet mass of the iris-ciliary body was measured at each obse rvation. Results: In Trial 1, WBC counts at day 1 were higher with a s ulcus-fixated IOL (P = .05). The median wet mass of the dissected afte r-cataract was 108.5 mg in eyes with a sulcus-fixated IOL and 62.5 mg in eyes with a capsule-fixated IOL (P =.01). In Trial 2, WBC counts at day 8 were significantly higher in eyes with a 7.0 mm CCC than in tho se with a 4.0 mm CCC (P <.05). There was no significant difference in the amount of after-cataract. Conclusions: The results indicate that I OL implantation in the capsular bag causes less inflammation and after -cataract formation than sulcus fixation and that using a large CCC do es not affect the total amount of after-cataract but may enhance the i nflammatory response.