Study on buckling of intraocular lens haptic in 2 types of intraocular lens material and its effect on vision.

Aim: To study the buckling of intraocular lens (IOL) haptics and its effect on vision in patients implanted with either hydrophilic or hydrophobic lens material. Study design: Prospective, observational and descriptive study. Setting: Tertiary eye care center in India. Material and methods: Patients operated for age-related cataract by phacoemulsification technique implanted with hydrophilic or hydrophobic IOL came either for follow-up surgery or complaints in an operated eye, being examined for visual acuity, refraction, anterior segment evaluation, and retinal examination. The position of IOL in terms of optic and haptics was noted and photographed. Results: 317 patients participated in the study. The mean age (SD) of the patients was 65 years (± 4.5). Of 317 patients, 127 (254 eyes) had bilateral, and 190 (190 eyes) had one eye IOL implantation. Out of 444 eyes, 254 (57.2 %) had hydrophilic and 190 eyes (42.8%) had hydrophobic IOL implantation. Buckling of IOL haptic was seen in 37 (8.3%) eyes of which 34 (13.9%) had hydrophilic, and 3 (1.6%) had hydrophobic IOL. Maximum eyes (n=20) with hydrophilic IOL presented during 1-3 years after IOL implantation. Major complaint for which patients came for follow up was blurring of vision (48.9%) and diminished vision (36.3%). Posterior capsular opacification (PCO) was observed in 2/ 190 (1.1%) eyes with hydrophobic and 28/ 254 (11%) eyes with hydrophilic IOL. Discussion: The present study dealt with the long-term performance of the haptics of the hydrophilic and hydrophobic IOLs in relation to its stability in the capsular bag. Conclusion: Buckling of haptic was seen more in the hydrophilic than in the hydrophobic IOLs. PCO was common in these eyes. Change in refraction occurred in eyes with hydrophilic IOL with buckling.

Reopacification of posterior capsular opening after ND: YAG capsulotomy: 2 cases with the different presentation.

Purpose: To report the complete opacification of posterior capsulotomy opening after neodymium: yttrium-aluminium-garnet (ND: YAG) posterior capsulotomy for posterior capsular opacification. Methods: A 70-year-old female had uneventful cataract surgery by phacoemulsification technique with implantation of in the bag hydrophilic intraocular lens (IOL) in her left eye. Eight months after surgery, the patient developed posterior capsular opacification (PCO) for which ND: YAG capsulotomy was performed. However, she returned after 7 months first post ND: YAG capsulotomy with the blurring of vision and glare at night. Slit lamp examination revealed pearl like opacification of posterior capsule occupying the YAG capsulotomy opening. A repeated ND: YAG capsulotomy restored her vision to 20/ 20. Another patient operated for posterior polar cataract had dehiscence in the posterior capsule during cataract surgery. The patient was implanted with hydrophobic IOL in the capsular bag without performing an optic capture. The patient presented 3 years later with occlusion of the posterior capsular opening with mixed pearl-like and fibrotic PCO. Conclusion: Occlusion of the posterior capsular opening may occur after ND: YAG capsulotomy and may cause a reduction in visual acuity. Pearl-like opacification is common to occur in reopacification of posterior capsular opening.