Publication Exclusive: Options exist for IOL insertion in presence of compromised capsular bag

In our routine cataract cases, we aim to put the IOL in the capsular bag because it provides a safe and secure position that will be stable over many years. But in situations in which there is compromise to the capsular bag or the zonular apparatus, we need to look at other options for IOL placement. With the cataract safely removed and the eye in the aphakic state, we need to examine the capsular bag integrity. Is the capsulorrhexis round, well-centered and continuous? Is the posterior capsule intact? When inflating the capsular bag with viscoelastic, does it shift or deform?