Single-piece foldable intraocular lenses versus three-piece intraocular lenses in the sulcus following posterior capsular rupture in a Philippine tertiary hospital

Aramis B Torrefranca Jr; Nilo Vincent Dg Florcruz; Noel S Carino; Richard C Kho

Return

Single-piece foldable intraocular lenses versus three-piece intraocular lenses in the sulcus following posterior capsular rupture in a Philippine tertiary hospital

Author: Aramis B. Torrefranca Jr. ^{1
,

2
,

3} ; Nilo Vincent Dg. Florcruz ^{1
,

4
,

5} ; Noel S. Carino ^{1
,

6} ; Richard C. Kho ^{1
,

5}
Author Information

1. Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila
2. Department of Ocular Health, Governor Celestino Gallares Memorial Medical Center
3. Bohol Eye and Ear Center, Ramiro Community Hospital
4. Department of Ophthalmology, DOH Eye Center, East Avenue Medical Center
5. American Eye Center, Inc.
6. Asia Pacific Eye Center
Publication Type:Journal Article
Keywords: Intraocular Implant; Cataract Surgery; Sulcus Implantation; Single-piece; Three-piece
MeSH: Philippines
From: Acta Medica Philippina 2024;58(15):67-73
CountryPhilippines
Language:English
Abstract: OBJECTIVE
Successful intraocular lens (IOL) placement in cataract surgery is synonymous with the IOL being placed in the capsular bag. When the capsular bag is violated, the ciliary sulcus becomes an option to approximate an inthe- bag position. Studies report that single-piece foldable acrylic (SPA) IOLs are a poor choice for the sulcus. This study aimed to report the visual outcomes and complications of sulcus placement of single-piece intraocular lenses and three-piece intraocular lenses, and compare the design and characteristics to the occurrences of complications.
METHODS
The medical records of patients were retrospectively reviewed in a single center from 2016-2019.
RESULTS
A total of 245 eyes from 237 patients were included in the study with a mean age of 61 years and male predominance. Majority of sulcus implantation occurred during phacoemulsification (87%). Around 82% (n=202) were implanted with single-piece IOLs and 18% (n=43) were three-piece IOLs. Best corrected distance visual acuity (BCDVA) was 20/20 after six months for both groups. Comparison between two groups showed no superiority with each other. Complications notable were elevated intraocular pressure, corneal edema, loss of IOL centration, and pigment dispersion. Smaller optic diameter and overall length predispose to higher probabilities of loss of centration. Pliability, hydrophobicity/hydrophilicity, and material do not correlate with postoperative complications. There were significantly higher numbers of pigment dispersions in IOLs with square-edged design.
CONCLUSION
In conclusion, visual outcomes remain equally excellent for both single-piece and threepiece groups. In contrast, there were more notable complications in single-piece group. Loss of centration tends to occur more with mean optic diameters lower than or equal to 5.50 mm and an overall length of less than 12.50 mm or lower. While appropriate for the capsular bag, square-edged designs were found to be inappropriate for the sulcus. The retrospective design does not allow strong inferences hence caution should be taken in correlating results.
Full text:202409150426266062210.pdf