Secondary in-the-bag implantation of intraocular lenses in aphakic eyes after vitreoretinal surgeries.

Background/aims: To report the accuracy of intraocular lens (IOL) power calculations and refractive outcomes in aphakic eyes after secondary in-the-bag IOL implantation.

Method: We retrospectively reviewed a consecutive case series of secondary in-the-bag IOL implantations in aphakic patients with intact capsular bag without severe capsular fibrosis between October 2006 and October 2010. Single-piece foldable lenses were secondarily implanted in 21 eyes of 20 patients. Postoperative best-corrected visual acuity (BCVA) and refraction were measured approximately 1 month after surgery. The accuracy of IOL power prediction was evaluated using the mean error (ME) and mean absolute error (MAE).

Results: Successful in-the-bag IOL implantation without capsular tear or defect was achieved in all eyes. The mean interval between phacoemulsification and IOL implantation was 5.4 months (range, 1.5-19 months). The ME was +0.06 dpt and the MAE was +0.24 dpt. The BCVA significantly improved from 0.66 logMAR at the pre-IOL implantation examination to 0.38 logMAR at the postoperative examination (p < 0.0001).

Conclusions: The postoperative refractive results are comparable with those of routine cataract surgery. Among the selected aphakic patients who underwent simultaneous phacoemulsification and vitreoretinal surgery, successful in-the-bag IOL implantation and satisfactory refraction were achieved after secondary IOL implantation.