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The capsular bag after short- and long-term fixation of intraocular lenses
E I Assia1, U F Legler, D J Apple
1Department of Ophthalmology, Meir Hospital, Sapir Medical Center, Kfar-Saba, Israel.
Purpose:
To investigate the effect of posterior chamber intraocular lens (PC IOL) size and construction on the capsular bag in human cadaver eyes.
Methods:
Studies were done at two timeframes: (1) short term (prospective)--the effect of 12 different IOLs on the capsular bag configuration after experimental implantation; and (2) long term--(retrospective) analysis of eyes with PC IOLs obtained post-morterm.
Results:
The short-term study showed the maximal diameter of the capsular bag to be 11.0 mm for IOLs with total diameter of 12.0 mm and 11.5 mm for 13.5- to 14.0-mm IOLs. Longer IOLs caused more ovaling of the bag with stress lines (striae) on the posterior capsule. Secondary processes such as proliferation of epithelial cells (Soemmering ring) and capsular fibrosis caused the capsular bag to resume a more circular shape with irregular contour. The area of contact between the IOL loops and the capsular equator was significantly lower in eyes with radial tears and IOLs with the J-loop design compared with the C-loop design. In both the short- and long-term groups, maximal capsular diameter did not exceed 12.0 mm.
Conclusions:
The results of this study suggest that using the capsulorrhexis technique, a 12.0-mm total diameter IOL is sufficient to provide stable capsular fixation.