Official ESCRS | European Society of Cataract & Refractive Surgeons


Sulcus implantation of three-piece intraocular lenses

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Session Details

Session Title: Cataract Surgery Complications

Session Date/Time: Monday 16/09/2019 | 16:30-18:00

Paper Time: 16:30

Venue: Free Paper Forum: Podium 2

First Author: : A.Liekfeld GERMANY

Co Author(s): :    S. Zoll                             

Abstract Details


To evaluate results and possible complications after IOL (intraocular lens) implantation into the sulcus ciliaris in complicated cases.


eye clinic, Klinikum Ernst von Bergmann gGmbH, Potsdam, Germany


Retrospective analysis after implantation of sulcus fixated IOL over the last 6 years was conducted. 28 eyes (25 patients with a mean age of 74 years) were included. Sulcus implantation of the IOL was carried out primary because of complicated course of surgery, e.g. posterior capsule rupture (13 eyes), or during lens exchange (9) or secondary after trauma or congenital cataract (6). The following three-piece IOL were implanted: AR40e (22 eyes), HOYA PY60 (4 eyes) and CT51LC (2 eyes). Follow-up period varied between 3 months and 5 years. Signs of iris depigmentation, intraocular pressure rise and IOL decentration were evaluated.


All eyes showed an open iridocorneal angel with increased pigmentation inferiorly. 17% of the eyes showed retrocorneal pigmented precipitates, 22% iris depigmentation. No eye developed secondary glaucoma. 35% of the IOL showed slight decentration (up to 1.5mm). Postoperative refraction resulted in slight myopia (average 0.75D) compared to calculated IOL power for capsular bag fixation.


Three-piece acrylic IOL seem suitable for sulcus implantation in special situations with capsular bag damages. They show stable long term results. However follow-up examinations should be carried out regularly for monitoring intraocular pressure, as increased deposition of pigment is observed. Concerning IOL calculation the induced myopic shift because of the further forward IOL position should be considered.

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