Reverse optic capture in cataract surgery: techniques, indications, and outcomes

Reverse optic capture (ROC) is a surgical technique in which the optic of an intraocular lens (IOL) is positioned anterior to the anterior capsulotomy opening, while the haptics remain within the capsular bag. Described originally as a method to secure fixation in cases of posterior capsular rupture, ROC has since evolved as a surgical maneuver to address fixation of an IOL in the setting of a not-intact posterior capsule, toric IOL rotation, treatment of negative dysphotopsia, and correction of unanticipated postoperative hyperopia. This review highlights the development, indications, and outcomes of ROC, as well as its advantages, limitations, and future directions. Additionally, we present a case of ROC utilized to treat negative dysphotopsia. As surgical techniques and IOL technologies continues to evolve, further prospective investigation will help clarify the role of ROC in achieving stable and predictable outcomes in complex cataract and refractive surgery.