Evaluation of 200 consecutive IOGEL 1103 capsular-bag lenses implanted through a small incision

We evaluated 200 consecutive IOGEL 1103 capsular bag intraocular lenses. We performed a 5 to 6 mm capsulorhexis and inserted the intraocular lens (IOL) through a 3.5 to 4.0 mm scleral tunnel with a Faulkner folder. Twenty-two cases were combined with trabeculectomy and ten with keratoplasty using a temporary keratoprosthesis. Mean follow-up was six months. The implant centered well and resisted capsular shrinkage. Iris touch to the optic was rare and did not provoke persistent pigment dispersion. In one third of the cases a cleft was discernible between the posterior convex IOL surface and the extended capsule despite thorough aspiration of viscoelastic and debris from the retrolental space. In 8% of cases, white flakes of unknown origin were observed at the IOL-capsule interface. In cases associated with pre-existing iritis or intraoperative iris trauma (iris manipulation, iridectomy, or synechiolysis in glaucoma patients), fibrin exudation as well as iridocapsular synechial formation and macrophage precipitation often ensued. Cellular precipitates, as evaluated by biomicroscopy and specular microscopy, were less pronounced and more transient than on poly(methyl methacrylate) IOLs. Best case visual acuity results were comparable to those with conventional implants; all eyes attained 20/40 or better and 97% achieved 20/25 or better. The 1103 was easier to implant through a capsulorhexis opening and suited the dimensions of the capsular bag better than the PC-12 model.