Capsulorhexis phimosis after bimanual microphacoemulsification and in-the-bag implantation of the Akreos MI60 intraocular lens

Abstract

An 80-year-old woman with corticonuclear cataract had cataract extraction by bimanual microphacoemulsification and in-the-bag implantation of the Akreos MI60 (Bausch & Lomb) intraocular lens (IOL). After 6 months, a complete capsulorhexis phimosis developed and surgery was performed to open and reduce the phimosis, with complete functional recovery. In the fellow pseudophakic eye, an acrylic hydrophobic Acri. Smart 48S (Acri.Tec) IOL had been implanted without complications. We conclude that a capsulorhexis phimosis may occur a few months after uneventful cataract surgery and in-the-bag implantation of the Akreos MI60 IOL.

Fellow-eye comparison of 2 aspheric microincision intraocular lenses and effect of asphericity on visual performance

“…[17][18][19] Although Can et al 18 report that the progressive resistance of the haptics of the Akreos MI60 IOL was designed to prevent capsular bag contraction and optic displacement, they report 3 eyes (3%) with anterior capsule phimosis. Cavallini et al 19 report a single case of anterior capsule phimosis with the Akreos MI60. Ali o et al 17 found 1 haptic of the Akreos MI60 IOL located outside the capsular bag; the IOL required surgical repositioning at 1 month.…”

Clinicopathologic correlation of capsulorhexis phimosis with anterior flexing of single-piece hydrophilic acrylic intraocular lens haptics

“…7 These and similar cases raise concerns about the behavior of highly flexible IOL designs in cases with excessive capsule fibrosis, 4 which may also occur in the absence of known risk factors such as pseudoexfoliation. 2,3 Of particular concern are IOLs designed for microincision cataract surgery, which are generally very thin and flexible, allowing tight rolling of the material without fractures or other damage. 3,8,9 Besides the possibility of a hyperopic shift due to posterior bowing of the IOL optic, excessive capsular bag fibrosis may lead to IOL decentration with symptoms such as those described by the patient in our first case due to the presence of the optic edge and/or the haptics in the pupillary area, among other complications.…”

“…2,3 Of particular concern are IOLs designed for microincision cataract surgery, which are generally very thin and flexible, allowing tight rolling of the material without fractures or other damage. 3,8,9 Besides the possibility of a hyperopic shift due to posterior bowing of the IOL optic, excessive capsular bag fibrosis may lead to IOL decentration with symptoms such as those described by the patient in our first case due to the presence of the optic edge and/or the haptics in the pupillary area, among other complications. Although the occurrence of excessive postoperative capsular bag fibrosis cannot be predicted in some cases, one should be aware of the possible risks of implanting highly flexible IOLs in the presence of known predisposing factors.…”

“…1 In some cases of excessive capsular bag contraction, no predisposing factor can be clearly determined. 2,3 We describe the pathological findings in 2 cases of excessive capsular bag fibrosis with capsulorhexis phimosis, leading to anterior flexing of the haptic components of single-piece hydrophilic acrylic IOLs. These and similar cases 4,5 raise concerns about the postoperative behavior of highly flexible IOLs.…”

Aspheric microincision intraocular lens implantation with biaxial microincision cataract surgery: Efficacy and reliability

“…Although all cases resolved with treatment, this complication should be kept in mind. We reviewed the recent literature related to this topic and found 1 case of capsulorhexis phimosis 38 in an eye with the aspheric microincision IOL model we used and 1 case of calcification in an eye with an Akreos Adapt Advanced Optics IOL, 39 which is of the same material as the IOL in our study. Therefore, more extensive studies or a metaanalysis should be performed.…”