this is the best article comparing IOL selection with loss of capsular support:
Wagoner MD, Cox TA, Ariyasu RG, Jacobs DS, Karp CL, Intraocular lens implantation in the absence of capsular support: a report by the American Academy of Ophthalmology. Ophthalmology. 2003 Apr;110(4):840-59
In the following video i show a recent case where i placed an AC IOL in a patient with a history of congenital cataract who is aphakic and intolerant to her contact lenses. we considered her options and decided to place an AC IOL as she had no history of glaucoma, had a normal angle, and was so young. we placed miochol to bring down the pupil, used Viscoat in case some of the OVD was retained in the vitreous, placed a peripheral iridotomy with the anterior vitrectomy handpiece, and closed the 6 mm scleral tunnel with 2 10-O nylon sutures.
Please always remember to place a peripheral iridotomy. i think this is best done with the anterior vitrector as shown in the video. I would like to show you pictures from a patient who came to me for a second opinion following complex cataract surgery about a year ago. during her surgery the functional support of the capsule was lost and the surgeon placed an AC IOL. the patient was bothered by a chronic head and brow ache and had elevated intraocular pressure. here is what she looked like that day:
You can see she has iris bombe and no patent peripheral iridotomy is visible. i took her to the laser and performed a Yag peripheral iridotomy. I chose a spot near the haptic at about 10 oclock as this region of the iris was posterior and safely away from the cornea. immediately following her Yag PI the iris bombe resolved and she was more comfortable. here is a picture from just a few days later showing the IOL and iris in good position.
