To the Editor.
—I read with great interest the article by Tsuboi et al1 in the August 1992 issue of the Archives and was amazed by the results obtained in their study.The authors found a higher permeability across the blood-aqueous barrier to fluorescein in in-the-bag intraocular lens (IOL) fixations than in the out-of-the-bag fixations after circular continuous capsulorhexis. However, they used the same IOL model (a three-piece 7-mm IOL with polypropylene loops) in both series of implants. Even if the total length of the IOL is not specified in the "Subjects and Methods" section, as would have been advisable, we can deduce that they used a 13.5- or 14-mm IOL. It is generally agreed nowadays that this type of IOL, designed for in-the-sulcus implantation, should not be inserted in the bag unless, of course, you wish to encounter foreseeable problems.A correct comparison between in-the-bag and in-the-sulcus fixation
Brusini P, Tsuboi S, Tsujioka M, Kusube T, Kojima S. In-the-Bag vs Out-of-the-Bag Intraocular Lens Fixation. Arch Ophthalmol. 1993;111(5):581. doi:10.1001/archopht.1993.01090050015005