Dr. Masket’s idea for designing an optic to permit anterior capsule fixation of the lens was based on experience showing that negative dysphotopsia does not occur or can be resolved when the IOL optic edge overlies the anterior capsulotomy, such as with sulcus placement or with reverse optic capture.
Although reverse optic capture and sulcus placement seem to prevent negative dysphotopsia, those techniques have other drawbacks that make them suboptimal for primary IOL implantation, Dr. Masket said.
“Reverse optic capture is associated with rapid development of posterior capsule opacification because the bulk of the IOL is not in the bag,” Dr. Masket explained. “With sulcus placement there are risks for long-term decentration and iris chafing. My concept for capturing the anterior capsulotomy with the anti-dysphotopic IOL mimics reverse optic capture but with in-the-bag implantation.
Dr. Masket added that the capsulotomy-fixated design offers advantages beyond absence of negative dysphotopsia.
“This arrangement avoids IOL rotation, making it ideal for toric IOLs, prevents capsule contraction, and greatly reduces tilt and decentration,” he pointed out. “Furthermore, if the capsulotomy is centered on the visual axis, there is no induction of higher order aberrations, which is very beneficial for multifocal IOLs.”