Hydroxypropyl methylcellulose remove dense water droplets during fluid-air exchange on the posterior surface of intraocular lenses with posterior capsule loss

Purpose: The research investigates the efficacy of hydroxypropyl methylcellulose (HPMC) treatment in facilitating the development of compact water droplets on the rear surface of synthetic lenses with capsule imperfections during the process of fluid-air exchange. Method: This study examined four patients with intraocular lens (IOL) implants and posterior capsule defects who experienced the formation of dense water droplets on the posterior surface following fluid-air exchange. When this occurrence obstructs fundus visualization during surgery, it is recommended to suspend the surgical procedure. Upon removal of the non-contact fundoscope and inspection of the IOL, the presence of dense water droplets becomes evident. Subsequently, the removal of bubbles can be achieved by employing a blunt needle filled with HPMC, which is subsequently administered to the area posterior to the intraocular lens. Subsequently, the HPMC should be uniformly distributed on IOL back surface using the blunt needle. Results: During the surgical procedure, it was noted that all patients attained a clear fundus field of vision after the administration of HPMC and insertion of the IOL, facilitating the successful execution of subsequent surgical procedures. Conclusion: HPMC serves as a suitable viscoelastic agent for the elimination of dense water droplets adhered to the surface of intraocular lenses following application, consequently maintaining a clear visual field of the fundus. This surgical intervention is characterized by its efficacy and safety.