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  • Cataract/Anterior Segment

    This prospective study evaluated the visual outcomes and safety of implanting a secondary IOL, Sulcoflex 653L (Rayner Intraocular Lenses Ltd.), in the ciliary sulcus to correct pseudophakic ametropia.

    Researchers used a piggyback technique to implant the IOL in 10 patients (12 eyes) who previously underwent phacoemulsification with IOL implantation in the capsular bag. Not yet available in the United States, the Sulcoflex 653L is a new foldable aspheric IOL designed for fixation in the ciliary sulcus. It is a single-piece hydrophilic acrylic IOL with a rounded edge and concave posterior surface. The authors, one of whom is a consultant to Rayner and collaborated in the design of the IOL, followed the subjects for 17 months.

    They found that mean spherical equivalent decreased from -1.25 D (range -2.00 to +4.00 D) preoperatively to 0.40 D (range -0.50 to +0.25 D) postoperatively. UDVA improved in all patients. There were no significant intraoperative or postoperative complications, and the IOL was well tolerated in all eyes. No eyes had signs of pigment dispersion, iris chafing or interlenticular opacification. Scheimpflug images showed that the distance between the primary and secondary IOLs remained stable during postoperative follow-up.

    The authors conclude that implantation of a secondary IOL in the ciliary sulcus is safe and predictable for correcting pseudophakic refractive errors, causing less trauma to surrounding tissues than would occur after IOL exchange. The results agree with previous studies suggesting that placing the primary IOL in the capsular bag and the secondary IOL in the ciliary sulcus prevents interlenticular opacification.