Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries

This research describes a novel technique to enhance the removal of residual lens epithelial cells that may remain in the capsular bag for in cataract surgery by rotating the intraocular lens to prevent the posterior capsular opacification. The primary treatment for PCO is capsulotomy. However, this procedure can cause changes to the shape of the posterior capsule, which may impact the placement of IOLs.

This could potentially lead to suboptimal long-term visual outcomes for patients with multifocal or toric IOLs. We have developed the IOL technique for preventing PCO in cataract co-surgery by rotating the IOL inside the capsule bag using an irrigation and aspiration tip. This method for preventing PCO is simple and cost-effective.

It only requires one additional step during cataract surgery, reducing the likelihood of PCO and the need for future treatments. We plan to perform extensive research on various IOL designs and PCO with a significant number of participants included in both rotating and non-rotating designs. Additionally, we will conduct in vitro experiments on animal eyes to determine the effects of IOL rotation on epithetical cells.

After preparing the patient and phacoemulsification device system, incise the cornea, and open the capsule with a continuous curvilinear capsulorhexis using Utralo capsulorhexis forceps under viscoelastic conditions. Perform cortical cleaving hydrodissection by injecting the Balanced Salt Solution or BSS under the anterior capsule flap using a blunt-tipped cannula. Perform hydrodelineation by injecting BSS into the substance of the nucleus to separate the harder nucleus from the peripheral softer nucleus.

Then select the Chop mode. Bury the phaco tip into the nucleus center and insert it under the anterior capsule flap, cracking the nucleus into two pieces. Next, set the machine to Irrigation and Aspiration mode.

Use an irrigation and aspiration tip to remove the soft depa nucleus and peripheral cortical material. Fill the capsule bag and anterior chamber with viscoelastics. Load a foldable single-piece intraocular lens into a prefilled injector cartridge with viscoelastic.

Now introduce the injector tip through the incision, and insert the IOL by pushing the injector tail, allowing the anterior haptic to spread into the capsular bag. Remove the viscoelastic from the anterior chamber, while rotating the IOL 360 degrees clockwise with posterior pressure using the irrigation and aspiration tip. Next, insert the irrigation and aspiration tip behind the optic part of the intraocular lens to aspirate residual fragments and viscoelastic inside the capsular bag.

After inserting the IOL into the capsular bag, as demonstrated earlier, use a Fenzl hook to rotate the intraocular lens clockwise at least 360 degrees. Slide the intraocular lens within the capsular bag side to side while applying slide pressure on the posterior capsule. A retroillumination image depicting posterior capsule opacification is presented.

One year following the surgical procedure, a clear and transparent capsular bag was observed.