When posterior capsule rupture occurs, the capsular bag may no longer provide stable in-the-bag support for a one-piece premium intraocular lens (IOL) ¹. In this situation, surgeons often implant a three-piece monofocal IOL.
Three-piece lenses consist of:
- A central optic (usually acrylic)
- Two thin haptics (often PMMA or polyimide)
Unlike one-piece acrylic lenses designed specifically for capsular bag placement, three-piece lenses are suitable for placement in the ciliary sulcus when capsule support is incomplete ¹.
They are mechanically stable and versatile in complex situations.
There are currently no widely used three-piece multifocal or toric lenses suitable for sulcus placement ². Therefore, when PCR occurs, the priority is to implant a stable monofocal lens and preserve ocular integrity.
Visual outcomes with three-piece monofocal lenses are excellent when centration is adequate ³.
Later refractive enhancement (for example supplementary sulcus lenses or laser correction) can address residual refractive needs if required.
Structural safety precedes refractive ambition.
References
- Oshika T, Sugita G, Miyata K, et al. Influence of intraocular lens design on stability and complications. J Cataract Refract Surg. 1998;24(10):1386-1392.
- Chang DF, Braga-Mele R, Henderson BA, Mamalis N, Vasavada A. Management of posterior capsule rupture. J Cataract Refract Surg. 2014;40(8):1360-1372.
- Royal College of Ophthalmologists. Cataract surgery guidelines. London: RCOphth; 2021.
Related Topics
- What is Posterior Capsule Rupture?
- Why is my risk of retinal detachment increased after PCR?
- Why is there increased cystoid macular oedema (CMO) after PCR?
- Why might my eye pressure rise after PCR?
- When will I be seen again after PCR?
- What does PCR mean for my bilateral surgery?
- Will my vision be ok after posterior capsule rupture?
- Will my vision be ok after dropped nucleus surgery following PCR?
- How long will the operation take if PCR occurs?
- Can I go to Moorfields for a second opinion instead?
- If I seek a second opinion, can I still have my corrective surgery at Blue Fin Vision®?
- What happens to my fees if I cancel the second eye after PCR?
- Is my risk higher for the second eye if I had PCR in the first?
- What is anterior vitrectomy and why is it performed after PCR?
- What is a three-piece monofocal lens and why is it used after PCR?
- What is a sulcus supplementary (Sulcoflex) lens?
- What is dropped nucleus and why does it happen after PCR?
- What is expulsive suprachoroidal haemorrhage and why is it mentioned with PCR?
- Why does pseudoexfoliation increase the risk of PCR?
- Why do very dense cataracts increase the risk of PCR?
- Is posterior capsule rupture negligence?
