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Safety of posterior chamber implants hinges on visualization
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 Georges D. Baikoff |
CHICAGO — Anterior segment optical coherence tomography enhances the accuracy of anterior chamber phakic IOL implantation but posterior chamber measurements are less accurate, a surgeon said here.
"We need to improve the exploration of the posterior chamber," Georges D. Baikoff, MD, said during Refractive Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and the Middle East Africa Council of Ophthalmology.
Anterior chamber lens implantation has its share of risks, Dr. Baijoff said. He noted that angle-to-angle and sulcus-to-sulcus measurements significantly influence the vaulting of anterior chamber implants, a key factor in safety and effectiveness.
Ultrasound biometry and OCT findings have shown that the edge of an anterior chamber implant must be at least 1.5 mm from the corneal endothelium to prevent endothelial cell loss, interference with the iris and pigment dispersion, Dr. Baikoff said.
The Artisan/Verisyse iris-fixated implants (Ophtec/Abbott Medical Optics) are not appropriate for eyes with anterior chamber depth of less than 3.2 mm, eyes with small anterior chamber diameter and eyes with increased crystalline lens height.
The risk of cataract development following posterior chamber implantation increases dramatically with age, Dr. Baikoff said.
There is no clear consensus on criteria for posterior chamber evaluation with UBM or OCT, he said.
- Disclosure: Dr. Baikoff has no direct financial interest in the products discussed in this article, nor is he a paid consultant for any companies mentioned.
Dr. Georges Baikoff points out some important key elements to the success of phakic IOLs. The main points of contention at this time are cataractous changes and endothelial cell loss. Both of these issues are related to the points of Dr. Baikoff’s comments. Without the proper sizing of the implant and an adequate anterior chamber depth, only trouble with the implant and the patient’s natural anatomy will follow.
— Karl G. Stonecipher, MD
Greensboro, U.S.A.
Disclosure: Dr. Stonecipher is a consultant for Abbott Medical Optics.