Clinical outcomes of a supplementary sulcus IOL
Reviewed by Ed Rule

In this retrospective study, the authors examined 31 eyes of 20 patients who had received a supplementary trifocal sulcus IOL in addition to a ‘bag-in-the-lens’ IOL. Implantation of a ‘bag-in-the-lens’ IOL requires the creation of anterior and posterior capsulotomies, followed by ‘sandwiching’ the two capsular leaflets into a groove around the edge of the IOL. This aims to prevent posterior capsular opacification while providing a stable placement of the IOL. The use of a supplementary sulcus IOL allows for correction of residual refractive errors and presbyopia while being relatively safer to implant compared to piggyback IOLs in the bag. The authors examined visual outcomes retrospectively and also administered a questionnaire to patients who had received the supplementary IOL. Although visual acuity outcomes were unchanged after supplementary IOL implantation, 80% of patients who responded to the questionnaire reported dysphotopsia. Only 53% of patients reported that they were satisfied with their vision. Supplementary IOLs from 13 eyes had to be explanted due to patient dissatisfaction or pigment deposits on the lens. These results are at odds with previously published research regarding the tolerability of supplementary sulcus IOLs, and may not be generalisable given the small sample size and unusual ‘bag-in-the-lens’ design of the primary IOL.

Clinical and surgical outcome of a supplementary multifocal intraocular lens implanted with a Bag-In-the-Lens intraocular lens: 5-year follow-pp.
Verdonck T, Werner L, Ní Dhubhghaill S, Tassignon M-J.
OPHTHALMIC RESEARCH
2021;64(3):503-11.