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Alcon sulcus lens

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However, optic capture by the anterior capsule is protective for IOL decentration, as shown by the lack of IOL decentration in the optic capture group. Decentration has been found to be the most common reason for explantation of foldable posterior chamber IOLs. The AQ V is silicone, however, which is not ideal in eyes which have often had vitreous loss during loss of posterior capsular support, leading to higher risk of retinal detachment and need for silicone oil later on.

The Sulcoflex, an IOL designed for the sulcus with 6. A limitation of the study is the inclusion of one patient with both eyes included, which may lead to a small correlation effect in statistical analysis. No other patients had a fellow eye which fit into the inclusion criteria of the study. The goal of this study, however, is to show that the MA50 is a stable lens for the sulcus in most eyes with a low-risk profile. Its desirable characteristics may outweigh the shorter loop-to-loop dimension in most eyes.

Placing the haptic in the sulcus with the optic prolapsed posteriorly seems to be the ideal position to limit the risk of decentration, iritis, and glaucoma. Eye Lond. Published online Jul 3. Author information Article notes Copyright and License information Disclaimer. E-mail: ude. Received Jan 12; Accepted Apr Results Fifty eyes of 49 patients meeting the inclusion criteria were identified. Conclusion The MA50 IOL is a reasonable, stable option for placement in the sulcus, with a low-risk profile; however, in eyes with longer AEL and presumably larger anterior segment, surgeons should consider placing an IOL with longer haptic distance than the MA50 to maintain centration.

Introduction In cataract surgery, a wide variety of pre-operative and intra-operative complications can necessitate the placement of a sulcus supported intraocular lens IOL. Materials and methods This is a retrospective cohort study examining cataract extraction with MA50 IOLs placed in the sulcus at University of Iowa Hospitals and Clinics from to Results The study population characteristics of the 50 eyes of 49 patients meeting the inclusion criteria are outlined in Table 1. Table 1 Study population characteristics.

Mean age Open in a separate window. Table 2 Most common reasons for IOL placement in sulcus. Table 3 Four-week follow-up data. Table 4 Comprehensive follow-up data. Table 5 Average axial eye length excluding eyes with optic capture.

Discussion The safety of an IOL in the sulcus is determined by multiple characteristics including large optic size, haptic length, lens material, angulation of haptics, shape of optic edge, and intra-operative ease of use, such as a foldable lens which uses a standard inserter. Notes The authors declare no conflict of interest. References Oetting TA. When and how should I implant an intraocular lens in the ciliary sulcus?

In: Chang DF ed. Chap 33, 1st ed. Complications of sulcus placement of single-piece acrylic intraocular lenses: recommendations for backup IOL implantation following posterior capsule rupture. J Cataract Refract Surg ; 35 8 : — Pigment dispersion with elevated intraocular pressure after AcrySof intraocular lens implantation in the ciliary sulcus. J Cataract Refract Surg ; 27 : — Secondary pigmentary glaucoma associated with piggyback intraocular lens implantation.

J Cataract Refract Surg ; 30 : — Pigmentary dispersion syndrome with a secondary piggyback 3-piece hydrophobic acrylic lens; case report with clinicopathological correlation. J Cataract Refract Surg ; 33 : — Elevated intraocular pressure in secondary piggyback intraocular lens implantation.

J Cataract Refract Surg ; 31 : — Consultation section. Cataract surgical problem. Explantation of intraocular lenses. Curr Opin Ophthalmol ; 11 : — Secondary intraocular lens implantation for pediatric aphakia. Use of AcrySof acrylic foldable intraocular lens for secondary implantation in children.

Clinical results with a supplementary toric intraocular lens for the correction of astigmatism in pseudophakic patients. Eur J Ophthalmol ; 25 4 : — Correction of undesirable pseudophakic refractive error with the Sulcoflex intraocular lens. J Refract Surg ; 28 9 : — The most common complications were pigment dispersion and iris transillumination defects, followed by IOL edge symptoms and elevated IOP.

Intraocular hemorrhage and cystoid macular edema were relatively infrequent. The authors hypothesized that the latter may have been underreported because of the retrospective nature of the data collection. Figure Gross photographs of pseudophakic human eyes obtained postmortem taken from the posterior or Miyake-Apple view.

A Single-piece lens with symmetric in-the-bag fixation. B Three-piece lens with symmetric in-the-bag fixation. C Three-piece lens with asymmetric bag-sulcus fixation. D Three-piece lens with symmetric sulcus fixation. Light photomicrographs of an explanted single-piece hydrophobic acrylic lens with asymmetric bag-sulcus fixation.

A Tip of the haptic that was in the bag, without pigment. B Tip of the haptic that was in the sulcus, with pigment dispersion. Similar complications have also been reported with 3-piece AcrySof lenses in a piggyback configuration or standard sulcus fixation. In piggyback implantation, fixation of the anterior lens in the sulcus has been recommended to prevent interlenticular opacification, which is the opacification in the interface between 2 IOL optics implanted within the capsular bag.

Two large studies from our laboratory, using pseudophakic human eyes obtained postmortem, highlight the importance of IOL selection for sulcus fixation. Anterior segment scanning of the eyes with a high-frequency ultrasound system or with a high-resolution anterior segment magnetic resonance imaging was performed followed by gross examination.

The eyes were processed for complete histopathological analysis. Some of the IOLs were explanted before histopathological evaluation to allow for direct light microscopic evaluation of the lenses. Eighteen eyes implanted with hydrophobic acrylic IOLs with anterior and posterior square optic edges had asymmetric or sulcus IOL fixation 6 with single-piece, 12 with 3-piece IOLs.

They were compared to the contralateral eyes with symmetric in-the-bag IOL implantation. Findings were more significant in comparison with the control contralateral eyes, and were particularly evident in relation to the sulcus-fixated haptic in the case of single-piece lenses Figure The majority of the eyes with 3-piece lenses showed signs of complicated surgery; therefore, all pathological findings in those cases could not be strictly attributed to the out-of-the-bag fixation.

In order to further understand these findings, we compared the previous series of 3-piece lenses square anterior and posterior optic edges to a series of eyes with out-of-the-bag fixation of 3-piece IOLs that had round anterior optic edges and similar signs of complicated surgery eg, posterior capsule rupture in a second study. Thirteen eyes had 3-piece hydrophobic acrylic IOLs with anterior and posterior square optic edges, and 14 eyes had 3-piece lenses with anterior round edges 13 silicone lenses and 1 hydrophobic acrylic lens without symmetric in-the-bag fixation.

These 27 eyes were processed for complete histopathologic analysis. Gross findings in both groups were composed of IOL decentration and tilt, pigment dispersion within the anterior segment and on the IOL surface, and iris transillumination defects. Additional changes observed in the 13 eyes with square-edged anterior optic IOLs included iris changes such as vacuolization, disruption, and loss of the pigmented epithelial layers; iris thinning and atrophy; synechiae; and pigment dispersion within the trabecular meshwork.

One eye also exhibited initial signs of optic nerve disc cupping.

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Best year dodge cummins to buy Most Viewed content is not available. Complications of sulcus placement of single-piece acrylic intraocular lenses: Recommendations for backup IOL implantation following posterior capsule source. The lens will also tend to decenter; then the surgeon will have to explant and lend the lens. Performance of the Sulcoflex piggyback intraocular lens in pseudophakic patients. Most Commented. So you should never put a single-piece acrylic lens in the sulcus.
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