Determination of properly sized capsulorhexis in lens subluxation to perform the best capsular bag fixation

The purpose of the study is to determine the appropriate anterior capsulorhexis size for the best capsular bag fixation in lens subluxation using iridocapsular retractors. Material and Methods. The patients were divided into three groups: group 1 included 48 eyes, group 2-50 eyes, group 3-46 eyes. A total of 144 patients (144 eyes) had lens subluxation of the first and second degree according to Pashtaev's classification. In group 1 we performed manual capsulorhexis with the mean diameter of 5.5 mm. In group 2 the diameter was 5.0 mm, and in group 3-4.5 mm. Nuclear density was classified as that of the second and fourth degree according to Buratto's classification. All patients underwent phacoemulsification with implantation of iridocapsular retractors and capsular ring. Results. The largest share of postoperative complications at 5.6% was observed in group 2, it was at 4.0% in group 3, and at 1.3% in group 2. The postoperative visual acuity increased significantly in all groups both at discharge and one year after surgery. Intraocular pressure was normalized in all patients at discharge and one year after surgery. Conclusion. The best capsular bag fixation in lens subluxation is achieved with a 4.5 mm capsulorhexis. However, the risk of anterior capsule damage increases. A 5.0 mm capsulorhexis is the most appropriate one for the best capsular bag fixation and comfort phacoemulsification.