Sulcus implantation of a single-piece foldable acrylic intraocular lens after posterior capsular rupture in cataract surgery.

Purpose: To evaluate the safety of a foldable acrylic single-piece intraocular lens (IOL) in cases of complicated cataract surgery and sulcus implantation. The setting was University and private anterior segment surgery practices.

Methods: In this observational case series study, 13 eyes of 13 patients were included after complicated phacoemulsification with extensive posterior capsule rupture with or without vitreous loss. A foldable acrylic single-piece IOL (Rayner Superflex 620H; Rayner Intraocular Lenses Limited, Hove, East Sussex, UK) was implanted in the ciliary sulcus in each eye. Postoperative follow-up included best-corrected visual acuity, anterior segment biomicroscopy, IOL centration and position, intraocular pressure, and fundus biomicroscopy. Optical coherence tomography was performed in 2 subjects. Median follow-up time was 12 months (range 1-21 months).

Results: Visual acuity 12 months after surgery was 6/18 and below in 5 eyes (39%), between 6/12 and 6/7.5 in 6 eyes (46%), and 6/6 in 2 eyes (15%). All patients experienced vision improvement. Postoperative complications included corneal edema (2 eyes), Descemet folds (1 eye), intraocular pressure elevations (3 eyes), and pronounced anterior segment inflammation (1 eye). Two eyes had minor pupil contour abnormalities. No significant IOL decentration was observed.

Conclusions: Sulcus implantation of a foldable acrylic single-piece IOL in eyes with complicated cataract surgery maintains the advantages of easy insertion and small incision. Postoperatively, all IOLs were centered, visual results were good, and complications were manageable and not IOL-related.