Pupillary capture of the optic in secondary piggyback implantation

Abstract

Two patients who received a minus-power intraocular lens implanted as a secondary piggyback to correct pseudophakic myopia experienced pupillary optic capture following dilation in the early postoperative period. Both cases were successfully managed by pressing the optic back into the ciliary sulcus and constricting the pupil with pilocarpine.

Secondary diffractive bifocal piggyback intraocular lens implantation

“…The most significant problems of this double implantation are interlenticular opacification, pupillary capture, and IOL decentration. [13][14][15][16][17][18][19] The correction of significant residual refractive errors after cataract surgery [3][4][5] or keratoplasty in pseudophakic eyes 20 by second monofocal IOL implantation in the ciliary sulcus has also been reported. Two studies report the benefit of piggyback IOL implantation in the capsular bag using a multifocal IOL during the same surgery.…”

“…A myopic IOL is also more likely to result in capture than the traditional IOL because of its thicker edge. 17 Gayton et al 17 describe a case in which pupillary capture was resolved by introducing a 30-gauge needle into the anterior chamber under topical anesthesia to press back the IOL and then instilling pilocarpine for 1 day. In our study, pupillary capture occurred in 2 eyes.…”

Sulcus anatomy and diameter in pseudophakic eyes and correlation with biometric data: Evaluation with a 50 MHz ultrasound biomicroscope

“…In the past, even multifocal IOLs were implanted in the sulcus to provide uncorrected near visual acuity. 8,9 However, these IOLs were not designed to be placed in the sulcus, and iris capture of the second IOL 10 or pupillary block with consequent glaucoma 11 have been reported.…”

Multifocal intraocular lens optic anteriorization capture to correct residual refractive error

“…However, postoperative IOP elevation, iris chafing, pigment dispersion syndrome, secondary glaucoma, and interlenticular opacification can occur after implantation of a second IOL. 27 Intraocular lens exchange is also an effective option for treating incorrect IOL power after cataract surgery if the source of the error is apparent and if the error is discovered early in the postoperative course. 28 One limitation of IOL exchange is that it is difficult to predict the power of the replacement IOL.…”