Refractive results of cataract surgery with posterior capsulorhexis and optic capture

Purpose. To compare refractive results in the following groups: after standard cataract surgery (1), standard cataract surgery supplemented with primary posterior capsulorhexis (2) and supplemented with a posterior capture of the IOL optics (3). Material and methods. This study included 32 patients (40 eyes) aged 52 to 68 years after uncomplicated phacoemulsification of age-related cataract with implantation of several models of monolithic flexible hydrophobic IOLs: Tecnis (J&J), enVista (B&L), RPR-2 (Reper-NN). The axial length of the eyes varied from 22.2 to 25,25 mm. The exclusion criteria were pseudoexfoliation syndrome and concomitant ophthalmopathology. Results. There were no intra- and postoperative complications in all studied groups. OCT monitoring showed the intactness of the anterior hyaloid in the second and third groups, the centered IOL position and the location of the capsular sheets according to the applied technology. The obtained refractive results were compared with the target refraction when calculating the IOL. The emmetropia was planned in all cases. However, because the strength of the lenses has discrete values with a step of 0.5 diopters, the closest value with a shift towards myopia was chosen. No statistically significant differences were found in the first and second compared groups when evaluating the refractive Results. However, the postoperative parameters were statistically significantly different in the third group with posterior optic capture. In this group a hyperopic shift of about 0,5 diopters was always observed. Conclusion. Primary posterior capsulorhexis with posterior optics capture provides a stable centered IOL position. The axial displacement of the IOL and the hypermetropic shift of the refractive results should be considered when planning posterior optical capture. Key words: posterior capsulorhexis, posterior optic capture, optic buttonholing