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Apple, D. J.
The most common complication of foldable intraocular lenses, both plate and haptic design, is malposition. Foldable silicone design IOLs have gained popularity because they can be easily inserted through a small cataract incision. However, some lenses, including plate designs, have a potential to decenter and rotate within the capsular bag. This raises concern regarding the stability of the plate design and in particular, the success of a toric plate IOL designed to correct astigmatism.
Dislocation following Nd:YAG laser capsulotomy is also a potential, although common, complication of this particular lens design. IOL configuration, flexibility, and absence of adherence to the capsule allows forces of tension to produce migration through the posterior capsular opening. Some surgeons advocate enlarging the positioning holes in the peripherial plate to allow adherence between the anterior and posterior capsule to anchor the lens and improve stability. We have studied this approach in a series of rabbits with IOLs and we do confirm that lens epithelial growth through a haptic hole may indeed help fixate the lens.
