The IOL Trap Technique Multipiece IOL in Sulcus with Optic Capture and CTR in Bag for Eyes with Weak

The IOL Trap Technique: Multipiece IOL in Sulcus with Optic Capture, and CTR in Bag for Eyes with Weak Zonules-Does It Work

2019

Author: Deepak Megur, FRCSEd

Purpose:

Traditionally in eyes with localized zonular dehiscence or moderate genaralized zonular weakness,both IOL & CTR are placed in the bag. This study aims to analyze the outcomes of the “IOL Trap technique” where in a multi-piece hydrophobic IOL is placed in the sulcus with optic capture along with a CTR in the bag in eyes with weak zonules..

Methods:

This was a prospective non comparitive study performed at secondary eye care facility, between January 2012 to December 2016.Eyes with traumatic subluxated cataracts with localized zonular dehiscence of less than 3 clock hours and eyes with moderate zonular weakness secondary to pseudoexfoliation were included. All eyes in the study underwent Phacoemulsification of nucleus & CTR implantation in the bag, and a multipiece hydrophobic IOL in sulcus with optic capture in the CCC. Outcome Measure studied were IOL centration & bag stability in the late postoperative period. The post operative evaluation was done over a period of 4 years at every 6 months.

Results:

28 eyes with zonular weakness were included in the study. 18 eyes had traumatic subluxated cataracts with localized zonular dehiscence of less than 3 clock hours and the remaining 10 eyes were of pseudo exfoliation with moderate generalized zonular weakness.The mean follow up was of 23.10 months,Best corrected vision of 20 /40 or better was achieved in 25 out of the 28 eyesGood IOL centration was noted in 26 of the 28 eyes during the entire course of the follow up. 2 eyes had minimal IOL de-centration owing to inadequate optic capture in the CCC .1 eye required Laser posterior capsulotomy for PCO.. Best corrected vision of 6 /12 or better was achieved in 25 out of the 28 eyes .

Conclusions:

The IOL Trap technique is a good option for select group of eyes with weak zonules. The CTR in the bag provides equatorial support to the bag while the multipiece hydrophobic IOL with its haptics in sulcus and optic trapped behind the CCC ensures a better weight distribution around the capsular bag resulting longterm stability of the bag.