J Korean Ophthalmol Soc.  2012 Mar;53(3):403-411.

Effects of Anterior Capsulotomy Extension on Rotational Stability of Intraocular Lens

• Kim KY
• Jin KH

Abstract

PURPOSE
To evaluate the effects of anterior capsulotomy extension on the rotational stability of four different types of intraocular lenses (IOLs) and to analyze factors influencing IOL rotation.
METHODS
The present single-center prospective study was comprised of 128 cataract patients (151 eyes) who underwent cataract surgery and received AcrySof IQ SN60WF, Tecnis ZA9003, Akreos MI60, or Zeiss XL Stabi ZO from March 2010 to December 2010. Sixty-four eyes received an anterior capsulotomy extension which was unintentionally created or performed using Vannas scissors after capsulorrhexis to prevent anterior capsular contracture. After pupil dilation, a digital retroillumination image of the IOL was taken on the operative day and 7 days postoperatively.
RESULTS
There was no statistically significant difference in IOL rotation between the 4 types of IOL (p > 0.05). The anterior capsulotomy extension group (2.72 +/- 2.42degrees) and the non-extension group (3.24 +/- 2.16degrees) did not show statistically significant differences in IOL rotation (p > 0.05). A positive correlation was observed between age and IOL rotation. Axial length, anterior chamber depth, and anterior chamber volume did not affect the degree of rotation.
CONCLUSIONS
Among the 4 types of IOLs, there was no significant difference in rotational stability. Anterior capsulotomy extension to prevent anterior capsular contracture is not likely to significantly affect the rotational stability of IOLs; the 4 different types of IOL were stable in the eye and suitable as toric IOLs for correction of astigmatism.

Keyword

Cataract surgery; IOL rotation stability; Toric intraocular lens

MeSH Terms

Anterior Chamber
Astigmatism
Capsulorhexis
Cataract
Contracture
Eye
Humans
Lenses, Intraocular
Prospective Studies
Pupil

Figure

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  Figure 1 Capsulotomy extension was performed using Vannas-scissor after capsulorrhexis. The yellow arrow indicated the 1-1.5 mm extending tear (XL Stabi ZO; Carl Zeiss Meditec SAS).

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  Figure 2 After confirmed maximum pupil dilation, photography of the IOL was taken directly at postoperative 1 day. Three reference axis were determined by taking 3 critical details; the optic center of the IOL, insertion of the haptics and one of the conjunctival vessels, episcleral vessels, or iris marking (SN60WF; Alcon).

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  Figure 3 Mean postoperative IOL rotation degrees between 4 types of IOL. *p-value: statistical significance was calculated by oneway-ANOVA.

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  Figure 4 Comparison of mean postoperative IOL rotation degrees between non-extension group and extension group. *p-value: statistical significance was calculated by independent t-test; †p-value: statistical significance was calculated by Mann-Whitney U-test.

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  Figure 5 Comparison of mean postoperative IOL rotation degrees between other factors -haptic types, optic-haptic angulation, viscoelastics, and IOL design. *p-value: statistical significance was calculated by independent t-test.

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  Figure 6 The scatterplots for mean difference of postoperative IOL rotation between age and postoperative rotation degrees (at 1 week after operation, r = 0.209, p < 0.05).

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