Capsular bag refilling using a new accommodating intraocular lens

PURPOSE: To describe a capsular bag refilling procedure using an accommodating intraocular lens (IOL). SETTING: Jinshikai Medical Foundation Nishi Eye Hospital, Osaka, Japan. METHODS: A disk-shaped anterior foldable silicone accommodating IOL that serves as an optical device and as a mechanical device to prevent leakage of the injected silicone polymers was developed. The IOL optic is 6.0 mm and the overall diameter, 9.0 mm. After a 3.5 to 4.0 mm continuous curvilinear capsulorhexis (PCCC) is created, phacoemulsification and aspiration are performed in the usual manner. Then, a posteriorly placed accommodating IOL with sharp edges is implanted in the capsular bag to prevent posterior capsule opacification (PCO) and leakage of the injected silicone polymer. A PCCC is an option at this point. Then, an anterior accommodating IOL is piggybacked over the existing IOL and silicone polymers are injected between the 2 IOLs. RESULTS: Experiments in numerous pig cadaver eyes and in 10 rabbit eyes showed minimal to no silicone leakage. In cases in which a PCCC was not created, 2 eyes had no PCO and 3 showed slight to moderate PCO. None of the 5 eyes with a PCCC had no PCO 5 to 8 weeks after surgery within the PCCC. CONCLUSION: The procedure in rabbit eyes overcame 2 problems of lens-refilling techniques: leakage of the injectable silicone polymer and capsule opacification.