Severe intraocular lens tilt after the Yamane technique

Area of Science:

• Ophthalmology
• Medical Device Analysis
• Surgical Complications

Background:

• Intraocular lenses (IOLs) are crucial for vision restoration after cataract surgery.
• Implantation without adequate capsular support presents unique challenges.
• CT Lucia 602 IOLs have been used in complex cases, necessitating evaluation of their performance and failure modes.

Purpose of the Study:

• To evaluate explanted CT Lucia 602 intraocular lenses (IOLs) that were implanted without capsular support.
• To document the condition of the IOL haptics and assess for the 'rotisserie effect' after explantation.
• To correlate clinical findings with pathological examination of the explanted devices.

Main Methods:

• A case series involving 13 explanted CT Lucia 602 IOLs, primarily implanted using the Yamane technique.
• Clinical data review for cases with decentration, dislocation, or optic tilt.
• Gross and microscopic examination of explanted lenses to assess haptic integrity and rotation, under both dry and hydrated conditions.

Main Results:

• A significant proportion of haptics were found to be deformed (15/26) or broken (6/26).
• Four haptics from Yamane-technique lenses explanted after November 2022 exhibited free rotation after hydration, indicating the rotisserie effect.
• Lenses explanted later showed severe optic tilt, suggesting a correlation with haptic issues and the rotisserie effect.

Conclusions:

• The rotisserie effect in CT Lucia 602 IOLs implanted via the Yamane technique is a documented phenomenon.
• Findings suggest that specific manufacturing batches may be associated with increased risk of haptic failure and rotation.
• This study highlights potential complications with CT Lucia 602 IOLs in cases lacking capsular support, particularly concerning haptic integrity and rotational stability.