gms | German Medical Science

Purpose: To provide an overview of the design and indications for implantation of the Sulcoflex intraocular lens (IOL) and evaluate piggyback implantation in postmortem pseudophakic human eyes by assessment of IOL fitting, centration, tilt, haptic position, and clearance with the primary IOL.

Methods: Pseudophakic human cadaver eyes were obtained within 72 hours of enucleation. Each eye was measured grossly then imaged by high-frequency ultrasound (Artemis, Ultralink) to assess the overall position of the primary IOL and sulcus diameter. The eyes were then injected with the Sulcoflex lens into the ciliary sulcus through a 3.0 mm clear corneal incision. After fixation in formalin, they were re-evaluated by high-frequency ultrasound for assessment of IOL fixation, fitting, centration, tilt, and clearance with the primary IOL and intraocular structures. Further analyses of the position of the Sulcoflex haptics in the sulcus were performed from the posterior or Miyake-Apple view, as well as from anterior and oblique views.

Results: All primary IOLs where located within the capsular bag. Different foldable IOLs were represented, as well as different degrees of Soemmering’s ring formation. The Sulcoflex could be injected and positioned within the ciliary sulcus, exhibiting overall excellent centration. Clearance between both lenses ranged from 232 to 779 microns, depending on the thickness of the primary IOL and the degree of Soemmering’s ring formation. Assessment of the sulcus fixated haptics revealed no disturbances to the ciliary processes.

Conclusion: In this ongoing study, the Sulcofex lens demonstrated appropriate fixation within the ciliary sulcus as was demonstrated by optimal centration, minimal or no tilt, and appropriate clearance with the primary IOL.