Posterior Segment Visualization in Eyes With Small-Aperture Intraocular Lens

PURPOSE: To evaluate the posterior segment visualization in patients with small-aperture intraocular lens (IOL) implantation. METHODS: In this prospective, comparative case series, 15 patients who had unilateral implantation of the small-aperture IOL in their non-dominant eyes were recruited. Their fellow eyes were pseudophakic with a monofocal IOL in 14 patients and phakic in 1 patient. All underwent bilateral posterior segment clinical investigations including fundus photography, threshold perimetry, and optical coherence tomography of the posterior pole including optic nerve head. The results from these investigations were graded by a clinician masked to the laterality and type of IOL. Patient 11 developed postoperative endophthalmitis 4 weeks following cataract surgery with implantation of a small-aperture IOL and underwent pars plana vitrectomy. The intraoperative view of the posterior segment was subjectively evaluated by the retinal surgeon. RESULTS: All 15 patients had successful image captures with all clinical investigative tools with no differences in image quality detected between the images obtained from the monofocal pseudophakic and small-aperture IOL eyes. The small-aperture IOL did not subjectively obstruct the intraoperative view for the retinal surgeon during pars plana vitrectomy. CONCLUSIONS: Standard posterior segment investigations including non-mydriatic fundus photography, optical coherence tomography, and automated perimetry can be safely and effectively performed in eyes with small-aperture IOLs. There is no difference in the image quality. [J Refract Surg. 2019;35(8):538-542.].