Long-term results of out-of-the-bag intraocular lens implantation

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.