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Five-step process may help with toric lens alignment
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KIAWAH ISLAND, S.C. — Using a practiced five-step process may help align toric lenses within the capsular bag, a surgeon said here.
Terry Kim, MD, said at Kiawah Eye 2009 that he places toric lenses approximately 15° to 20° short of the intended axis, with viscoelastic still buoying the lens from behind. Next, viscoelastic is removed from behind the device using a 45° irrigation and aspiration tip.
"I like to remove all the viscoelastic from behind to avoid capsular bag distention syndrome or myopic shift," Dr. Kim said. "Make sure that the port is fixed in the cornea, because if you have a lax posterior capsule, you can snag it."
Viscoelastic is left in the anterior chamber to maintain shape, while a secondary alignment is performed, this time moving the lens to within 5° of the axis.
"By this time, the lens is fully expanded, so you're not going to see rotation," he said.
The I&A tip is used to remove viscoelastic; Dr. Kim said he prefers a dispersive viscoelastic in all cases. Lastly, a paracentesis incision is made, through which the balanced salt solution cannula is inserted to hydrate the wound and fill the anterior chamber before the final alignment is made.
Kiawah Eye 2010 will be held May 13-15, 2010 at the Kiawah Island Golf Resort in South Carolina. Learn more at KiawahEye.com.