Outcomes of secondary in-the-bag intraocular lens implantation following phacovitrectomy

To evaluate the anatomical and refractive outcomes of secondary in-the-bag intraocular lens (IOL) implantation following phacovitrectomy with anterior capsule polishing, by comparing it with primary IOL implantation.

Fifty-two patients who underwent phacovitrectomy were included in this prospective study and divided into two groups based on IOL implantation timing. Postoperative IOL tilt, decentration, objective optical quality, and refractive prediction error were compared between the secondary and primary groups at 3 months postoperatively.

The mean IOL tilt and decentration were 4.93 ± 1.52° and 0.23 ± 0.21 mm in the secondary group, and 4.75 ± 1.82° and 0.23 ± 0.14 mm in the primary group (P > 0.05 for both). For objective optical quality, no significant differences were found in intraocular and ocular higher-order aberrations, higher-order modulation transfer function, and Strehl ratio between the two groups for 3 mm and 5 mm pupils. The primary group exhibited a slight hyperopic shift, with a mean prediction error of 0.54 ± 0.41 D, which was significantly higher than that of the secondary group (- 0.05 ± 0.70 D; P = 0.001). However, there was no difference in mean absolute error between the two groups.

Secondary in-the-bag IOL implantation is a viable option following phacovitrectomy with anterior capsule polishing, offering a good IOL position and satisfactory refractive outcomes.