Posterior chamber intraocular lens implantation after capsular tear: Ultrasound biomicroscopy evaluation

Purpose: To evaluate by ultrasound biomicroscopy (UBM) the exact position of a posterior chamber intraocular lens (PC IOL) implanted above a posterior capsule tear and to correlate the findings with the outcomes and complication rate. Setting: Department of Ophthalmology, Rabin Medical Center, Petah Tiqva, Israel. Methods: In a retrospective noncomparative case series, 36 patients (36 eyes) who had extracapsular cataract extraction (ECCE) complicated by capsular tear were evaluated. In all cases, a PC IOL was implanted above the remnant of the capsule without suturing. Ultrasound biomicroscopy was performed to study the exact position of the optic and haptic. The outcomes and complication rate were determined from patient examinations performed during a follow-up of 1 to 6 years. Results: Optic tilt was found in 20 of 36 patients (56%). In 17 patients (47%), both haptics were located in the sulcus. In 15 patients (42%), 1 haptic was observed in the sulcus and 1 in the bag or elsewhere. No correlation was found between the position of the optic and the location of the haptics. Minimal postoperative complications were observed, and only 1 patient required another surgery for a dislocated IOL. Conclusion: By UBM, half the patients had optic tilt and more than half the IOLs were not implanted in the sulcus, the intended location.