Capsular peeling in premium IOLs to improve visual outcome

Purpose To demonstrate that capsular peeling may improve quality of vision of patients who experienced reduced vision in the short postoperative period after premium IOL implantation due to decentration of the IOL secondary to PCO. Methods Patients who were refered to our centre because of unsatisfactory quality of vision after premium IOL implantation (more specifically after multifocal IOLs) were scheduled for surgery aiming at peeling the capsular bag. The conditions which the patient needed to meet were: increased higher order aberrations, evidence of tilt or decentration of the IOL, important fibrotic proliferation in the capsular bag, no YAG laser capsulotomy performed. Results After capsular peeling, it was possible to demonstrate that the quality of vision of the patient improved, the higher order aberrations reduced and it was often unnecessary to explant the premium IOL. Although there was an obvious improvement of the quality of vision, this improvement still did not reached the high standard of vision as measured after monofcal IOLs. Conclusion This paper shows how important the role is of PCO on quality of vision. Because contrast sensitivity is already reduced after premium IOL implantation, patients will be very sensitive to an additional reduction as it appears after PCO.