Three-Piece Intraocular Lens Sulcus Implantation After Posterior Capsule Rupture: A Six-Year Review At Royal London Hospital Ophthalmology Department.

• To assess visual outcomes following 3-piece IOL sulcus implantation for PCR over a five-year interval (April 1, 2019, to March 31, 2024).
• To examine how patient- and surgery-specific factors—such as axial length, pupil size, vitreous loss, preoperative PCR risk calculation, ocular co-pathology, and surgeon seniority (consultant vs. trainee)—influence visual outcomes

The Royal London Hospital and Whippscross Hospital, London, UK between April 1, 2019, to March 31, 2025

A retrospective review was conducted of patients at RLH and Whipps Cross who experienced PCR and underwent 3-piece IOL sulcus implantation (Bausch & Lomb Sofport LI61AO) between April 1, 2019, and March 31, 2025. Data on pre-, intra-, and postoperative parameters were collected, including predictive refraction, corrected distance VA, ocular co-pathology, preoperative PCR risk assessments, biometry conversion formula used, and surgeon experience level.

Twenty-eight patients met the inclusion criteria.

• Two patients (7%) experienced a loss of ≥0.3 LogMAR (doubling or worse of the visual angle).

• The average postoperative VA was 0.2 LogMAR, and the mean VA gain was 0.62 LogMAR.

• The influence of factors such as axial length, pupil size, ocular co-pathology, and surgeon seniority (trainee vs. consultant) on postoperative VA outcomes was noted but requires further stratified analysis for definitive conclusions.

Sulcus implantation of three-piece IOLs following PCR can achieve favorable postoperative visual acuity. Moving forward, robust assessment of patient- and surgery-specific parameters—particularly in higher-risk groups— together with a meticolous use of biometry conversion formula used for ciliary sulcus lens,  will be essential to further optimize cataract surgery outcomes.