Artikel
Secondary IOL Implantation: Which Choice?
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Veröffentlicht: | 18. Juni 2008 |
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Gliederung
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Purpose: Aim of this presentation is to show the options in case of secondary implant or IOL exchange in post-traumatic cases.
Methods: We present a case series in which a posterior iris-claw IOL (Ophtec Artisan) and a cosmetic IOL (Ophtec RF 311) are used.An anterior 25 gauge infusion and triamcinolone-assisted anterior vitrectomy when necessary are used.The posterior iris-fixed IOL is inserted through a corneal tunnel at 12 o’clock. The IOL is grasped with a forceps and the iris tissue is captured in the haptics using a spatula trough a paracentesis. At 3 and 9 o’clock.The cosmetic IOL is implanted by scleral fixation or on the anterior capsula, when present. When possible, a pupillary plasty is performed, using the iris remnants.Those techniques are performed “open sky” or“closed eye”.
Results: One case or iris.claw subluxation in 196 implant since 2002 to 2007. The triamcinolone helps to show capsular residuals useful to the possible implantation, being guided the surgeon in the choice of this last one. In the series of cosmetic IOLs (28 cases since 2002 to 2007), none case of (sub)luxation and 4 cases of anterior and intermediate uveitis.
Conclusions: The choice of the IOL implantation depends on the degree of involvement, of the bag-zonula system. The posterior iris-fixed IOL is a valid alternative to the conventional scleral-fixed IOL. The cosmetic IOL is a good solution in cases of functional and hestetical problems. The 25G anterior infusion and the use of triamcinolone is indicated in these cases.