Intraoperative Learning Curve Using Anterior Capsule Fixation Iol

Effective lens position is an important cause of biometric error following cataract surgery. This is even more important in patients who have undergone multifocal implantation. Anterior lens capsule fixation aims to solve this issue, by clippinng the lens to the anterior, the effective lens position is fixed, hence improving biometric error. The aim of this study is to describe the learning ccurve of capsulr fixation in a series of consecutive patients. 

Singapore National Eye Centre 

This was a prospective, single surgeon consecutive series of 100 eyes that underwent femtis IOL implantation. Surgical videos were examined following cataract removal. All patients underwent femtosecond laser assisted cataract surgery, with the same capsulotomy size in all cases. The capsulotomy and fragmentation was performed with the Z8 laser. The IOL surgical implanation time and time to fixation was noted in all cases. In addition any complications were noted. 

All capsulotomies were created without complication. Following phacemulsification, there was 1 case of posterior capsule rupture noted. All cases had femtis IOL implantation. Enclavation took a mean time of 90seconds, in addition to the surgical time. The first 10 cases tooke significantly longer than the last 10 cases. It took 15 cases to reach a status in the learning curve. Surgical technique was adapted in cases of posterior capsule rupture with the lens injected into the posterior chamber and clipped in reverse. 4 cases had displacement of one flange following viscoelastic removal, the flange was replaced without complication. 

The learninng curve with anterior capsule fixation lenses is short, and can be overcome following 10 cases. Variation inn technique will allow implantation in complex situations, in addition care should be noted following viscoelastic removal to avoid flange subluxation.