Primary implantation of posterior chamber intraocular lenses in eyes with defective posterior capsule

Primary implantation of posterior chamber intraocular lens (PC IOL) was performed in 70 eyes with defective posterior capsule following extracapsular cataract extraction. The visual acuity was 0.5 or better at 3 months and 12 months postoperative in 97.1% and 88.6% of the cases respectively. Complications were rare. The authors put forth the following principles for such cases: (1) injection of air or Healon to maintain a deep anterior chamber: (2) the insertion or rotation of the IOL should be away from the area of capsular rupture; (3) the long axis of the IOL should cross the meridian of the posterior capsule rupture: (4) the residual anterior capsule may be utilized to support the IOL; (5) complete clearance of any vitreous in the anterior chamber; and (6) performance of at least 2 peripheral iridectomies to guard against pupillary block. This technique is applicable in eyes with peripheral posterior or capsule defect of less than 120 degrees or with central rupture of less than 4mm.