A comparison of ciliary sulcus and capsular bag fixation of posterior chamber intraocular lenses.

We compare indications, advantages, and disadvantages of ciliary sulcus and lens capsular bag (lens capsular sac) fixation of posterior chamber intraocular lenses (IOLs). Our findings suggest that, whenever possible, it is efficacious to implant the loops of posterior chamber IOLs within the capsular bag. This positions the lens optic and the supporting loops in the natural anatomical position, sequestered from highly vascular uveal tissue and the blood aqueous barrier. This should minimize the potential for complications that may be associated with iris-ciliary body contact. Considering the rapid increase in the number of implantations of IOLs now being performed (approximately 700,000 per year in the United States alone), a possible reduction of even 1% in clinically significant complications would make this effort worthwhile. Widespread application of in-the-bag implantation is predicated on the assumption that the surgeon is proficient with this procedure and that careful follow-up of patients does not reveal any significantly increased incidence of lens dislocation due to zonular rupture.