Purpose: To evaluate long-term results of out-of-the-bag intraocular lens (
IOL) implantation.
Setting: Department of Ophthalmology, Tenri Yorozu Hospital, Nara, Japan.
Methods: This study comprised 22 patients, 13 women and 9 men, who had cata
ract surgery by phacoemulsification and out-of-the-bag IOL implantation bec
ause of a posterior lens capsule rupture. Sixteen patients had in-the-bag I
OL implantation in the fellow eye, and these eyes were used as a control gr
oup. The IOL's position was determined by ultrasound biomicroscopy (UBM). A
nterior chamber flare counts were measured by a laser flare meter. The corn
eal endothelium was observed by specular microscopy.
Results: Mean follow-up after cataract surgery was 35 months +/- 22 (SD). T
he UBM revealed that in the 19 eyes with sulcus-to-sulcus IOL fixation, the
optics touched the iris. In 3 eyes, 1 haptic was fixated at the sulcus and
the other at the ciliary body. In 2 of these eyes, the optics did not touc
h the iris. Anterior chamber flare counts in eyes with sulcus-to-sulcus IOL
fixation were significantly higher than in eyes with in-the-bag or sulcus-
to-ciliary-body fixation (P < .05). There were no statistical differences i
n corneal endothelial cell counts based on haptic placement.
Conclusion: Rubbing between the IOL optic and iris seems to contribute to t
he high flare counts in eyes with a sulcus-to-sulcus IOL fixation. A larger
haptic angle may be needed to prevent contact between the iris and IOL opt
ic in such cases. (C) 2000 ASCRS and ESCRS.