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    Reverse optic capture effective for posterior capsule tears



    Dr. Hoffman noted that the Cataract Clinical Committee of the American Society of Cataract and Refractive Surgery has emphasized that single-piece IOLs should not be implanted into the ciliary sulcus without fixation because of the risk of pigment dispersion, glaucoma, uveitis, and recurrent vitreous hemorrhages.

    Recent: How new ‘evolving’ IOL formula maximizes lens accuracy

    “However, it may be OK to put single-piece IOLs in the bag and perform reverse optic capture,” said Dr. Hoffman, recounting a recent study of the procedure performed in 16 eyes, with 12 of the fellow eyes serving as controls (Ophthalmic Surg Lasers Imaging 2012;43:480-8).

    The authors reported that patients achieved 20/25 or better vision in 94% of the eyes in which the reverse optic capture was performed compared to 92% in the control eyes. In both groups, 94% and 100%, respectively, were within 1 D of the intended correction. The IOLs in all eyes that underwent reverse optic capture remained centered, and no vision-threatening complications occurred after 19 months of follow-up.

    Related: Laser cataract surgery continues to transform capsulotomies

    The study concluded that reverse optic capture of a single-piece acrylic IOL through an anterior capsulorhexis merits consideration for IOL placement in selected cases of insufficient posterior capsule support.

    More: View the top news recap from ARVO and ASCRS!


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    • [email protected]
      I also use the Hoya iSert IOL used in this video. I have had 2 suspected cases of equatorial PC tears both of which did well with IOL rotation away from the suspected tear. No vitreous presentation occurred. The IOLs have stayed stable. This is an excellent technique for securely fixating the IOL. My recommendation when using this IOL is to pull back a little once the optic has cleared the injector so as not to push the IOL too far towards the equator. With the exception of this particular problem, I find this IOL one of the easiest to insert, haptics never stick, excellent optics, and so far a very low PCO rate.


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