Systematic surgical procedures to secure more stable in-the-bag intraocular lens fixation

Managing inferior zonule tears during manual extracapsular cataract extraction

We describe a new technique for safely concluding manual extracapsular cataract extraction in the presence of a rupture of the interior zonules. A lens glide is inserted in the anterior chamber. The tip of the glide is placed in the inferior part of the capsular bag, pushing it toward the ciliary sulcus at 6 o'clock. The extraocular part of the glide is sutured to the sclera to prevent its displacement during manipulation of the eye. The glide spreads the rolled inferior capsule, allowing aspiration of retained cortical material and in-the-bag intraocular lens implantation. The glide is then removed. This technique was used in 12 eyes with pseudoexfoliation in which the complication occurred. No vitreous loss, lens displacement, or other intraoperative or postoperative complications were observed.

The Binkhorst Medal Lecture. Biologic relationship between poly(methyl methacrylate) intraocular lenses and uveal tissue

Implantation of a poly(methyl methacrylate) (PMMA) intraocular lens (IOL) after cataract surgery is associated with breakdown of the blood-ocular barrier and a foreign body inflammatory response. Although the material is biocompatible, it is not inert. The history of PMMA IOL implantation has reflected mechanical, chemical, and immunological interactions between the IOL and ocular tissues. The common link in these events is instability of the blood-ocular barrier. In this lecture, I discuss the nature of these interactions and present evidence that currently investigated methods of surface modification and capsular bag IOL implantation are effective in stabilizing the blood-ocular barrier.