An improved two-steps method for secondary in-the-bag intraocular lens implantation in aphakia eye

To describe an improved technique for secondary IOL implantation in constricted capsular bag in aphakic eyes.

This study was designed and carried out in the department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital).

This is a retrospective study which evaluate the post-operative effect of the two-steps secondary IOL implantation.

21 eyes of 21 patients who underwent primary cataract surgery from June 2020 to September 2020 were enrolled. Two-steps IOL implantation was performed. Patients were followed up with ophthalmic examinations.

Of all 21 eyes, the capsular bags were reopened and the IOL were implanted into the bag. During follow-up, the mean age was 62.3 ± 7.3 (range, 44-81) years and mean interval between the primary surgery and secondary IOL implantation was 23.5 ± 9.6 (range, 4.1-78.3) weeks. A marked improvement of postoperative mean BCVA was noticed (pre 20/84 Snellen, 0.62 ± 0.26 logMAR equivalent, and post 20/44 Snellen, 0.34 ± 0.33 logMAR equivalent; p = 0.001). The mean SE also improved from + 10.32 ± 5.05D at baseline to -2.68 ± 1.36D at the last follow-up time (p < 0.001). The mean IOP showed no significant difference (pre 17.62 ± 4.66 mmHg, post16.84 ± 4.73 mmHg; p = 0.6860) and the corneal endothelial cell density decreased about 11.04 ± 10.84% (from 2483 ± 218.43 cells/mm² to 2190 ± 361.36 cells/mm² p = 0.0029).

The two-steps capsular bag reopening method can be achieved in majority of cases with stable IOL position and better visual outcome.