New IOL designed for piggyback sulcus fixation shows promise

Researchers evaluated a new, single-piece hydrophilic acrylic IOL designed for sulcus fixation in a piggyback configuration in 11 pseudophakic cadaver eyes with different overall sizes, Soemmerring ring formation and in-the-bag IOLs. The Sulcoflex has large optic and overall diameters, smooth and undulating haptics and a convex–concave optic profile. Results showed that these characteristics minimize the possibility of interaction with the primary IOL and uveal tissues, decreasing the likelihood of optical aberrations and pigmentary dispersion.

It was nice to see that the Sulcoflex behaved as predicted in all eyes. This lens was specifically designed as an add-on for sulcus implantation. It is a pity it is not available in the U.S.

The Sulcoflex could be injected and positioned in the ciliary sulcus and had overall appropriate centration and minimum or no tilt. Clearance between the two IOLs ranged from 232 to 779 μm, mostly depending on the thickness of the primary IOL. Direct assessment of the sulcus-fixated haptics showed no disturbances to the ciliary processes.

The authors note that the Sulcoflex IOL can also be used to manage such things as refractive changes in pediatric eyes. The surgical trauma associated with Sulcoflex IOL implantation is significantly less than that occurring after explantation/exchange of an in-the-bag IOL, they write, especially after a long-term postoperative period. Therefore, they believe the concept of the Sulcoflex as a supplementary IOL is attractive and deserves further study.