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Kim and Jin: Effects of Anterior Capsulotomy Extension on Rotational Stability of Intraocular Lens
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(3): 403-411.

Published online: 15 March 2012

DOI: https://doi.org/10.3341/jkos.2012.53.3.403

Effects of Anterior Capsulotomy Extension on Rotational Stability of Intraocular Lens

Kook Young Kim, MD, Kyung Hyun Jin, MD, PhD

Department of Ophthalmology, KyungHee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.

Address reprint requests to Kyung Hyun Jin, MD, PhD. Department of Ophthalmology, KyungHee University Medical Center, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Korea. Tel: 82-2-958-8451, Fax: 82-2-966-7340, khjinmd@khmc.or.kr

Received 27 May 2011       Accepted 29 February 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To evaluate the effects of anterior capsulotomy extension on the rotational stability of four different types of intraocular lenses (IOLs) and to analyze factors influencing IOL rotation.

Methods

The present single-center prospective study was comprised of 128 cataract patients (151 eyes) who underwent cataract surgery and received AcrySof IQ SN60WF, Tecnis ZA9003, Akreos MI60, or Zeiss XL Stabi ZO from March 2010 to December 2010. Sixty-four eyes received an anterior capsulotomy extension which was unintentionally created or performed using Vannas scissors after capsulorrhexis to prevent anterior capsular contracture. After pupil dilation, a digital retroillumination image of the IOL was taken on the operative day and 7 days postoperatively.

Results

There was no statistically significant difference in IOL rotation between the 4 types of IOL (p > 0.05). The anterior capsulotomy extension group (2.72 ± 2.42°) and the non-extension group (3.24 ± 2.16°) did not show statistically significant differences in IOL rotation (p > 0.05). A positive correlation was observed between age and IOL rotation. Axial length, anterior chamber depth, and anterior chamber volume did not affect the degree of rotation.

Conclusions

Among the 4 types of IOLs, there was no significant difference in rotational stability. Anterior capsulotomy extension to prevent anterior capsular contracture is not likely to significantly affect the rotational stability of IOLs; the 4 different types of IOL were stable in the eye and suitable as toric IOLs for correction of astigmatism.

Keywords: Cataract surgery, IOL rotation stability, Toric intraocular lens

Figures and Tables

Figure 1
Capsulotomy extension was performed using Vannas-scissor after capsulorrhexis. The yellow arrow indicated the 1-1.5 mm extending tear (XL Stabi ZO; Carl Zeiss Meditec SAS).
jkos-53-403-g001
Figure 2
After confirmed maximum pupil dilation, photography of the IOL was taken directly at postoperative 1 day. Three reference axis were determined by taking 3 critical details; the optic center of the IOL, insertion of the haptics and one of the conjunctival vessels, episcleral vessels, or iris marking (SN60WF; Alcon).
jkos-53-403-g002
Figure 3
Mean postoperative IOL rotation degrees between 4 types of IOL. *p-value: statistical significance was calculated by oneway-ANOVA.
jkos-53-403-g003
Figure 4
Comparison of mean postoperative IOL rotation degrees between non-extension group and extension group. *p-value: statistical significance was calculated by independent t-test; †p-value: statistical significance was calculated by Mann-Whitney U-test.
jkos-53-403-g004
Figure 5
Comparison of mean postoperative IOL rotation degrees between other factors -haptic types, optic-haptic angulation, viscoelastics, and IOL design. *p-value: statistical significance was calculated by independent t-test.
jkos-53-403-g005
Figure 6
The scatterplots for mean difference of postoperative IOL rotation between age and postoperative rotation degrees (at 1 week after operation, r = 0.209, p < 0.05).
jkos-53-403-g006
Table 1
Demographic characteristics of intraocular lenses
jkos-53-403-i001
Table 2
Comparisons of mean difference in rotations of 4 types of IOL on operative day and 7 days postoperatively
jkos-53-403-i002

*Statistical significance was calculated by paired t-test.

Table 3
Relationship between rotation degrees and axial length, anterior chamber, and age
jkos-53-403-i003

*Statistical significance was calculated by multiple logistic regression analysis.

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