Effect of anterior capsulorhexis optic capture of a sulcus-fixated intraocular lens on refractive outcomes

PURPOSE: To assess the effect of optic capture on the achieved refractive outcome after complicated cataract surgery with a sulcus-fixated intraocular lens (IOL). SETTING: Sunderland Eye Infirmary, Sunderland, United Kingdom. DESIGN: Single-unit, single-surgeon retrospective case-note review. METHODS: The case notes were reviewed of patients who had vitrectomy for retained lens matter after phacoemulsification or phacoemulsification with posterior capsule rupture and sulcus fixation of a posterior chamber IOL by the same surgeon. Capsulorhexis capture was attempted in all patients. RESULTS: Fifty-eight eyes of 58 patients were included. The mean age was 74 years (range 47 to 99 years). Twenty-four patients (41%) had optic capture, and 34 patients (59%) had an IOL placed in the sulcus without optic capture. There was no statistically significant difference in age, axial length, or IOL power used between the groups. The mean refractive difference was +0.34 diopter (D) with optic capture and -0.40 D without optic capture (P=.0002). CONCLUSIONS: The mean refractive difference for a sulcus IOL with and without optic capture was 0.74 D, equating to an IOL power change of approximately 1.00 D. The refractive results were very similar to the surgeon's personal refractive outcomes using the same IOLs in the bag (mean error +0.28), suggesting that anterior capsulorhexis optic capture gives similar results to placing an IOL in the bag. FINANCIAL DISCLOSURE: Drs. Steel and Allen have received traveling expenses from Alcon Laboratories, Inc. to attend international meetings and have attended Alcon advisory board meetings. No author has a financial or proprietary interest in any material or method mentioned.