This article is more than 5 years old. Information may no longer be current.
Surgeon shares pearls on avoiding, managing complications in cataract surgery
 Michael B. Raizman |
PHILADELPHIA — Meticulous preparation, a willingness to try different techniques and keen attention to dislocated IOLs are critical in preventing and managing cataract surgery complications, a speaker said here.
"Being prepared in advance makes a big difference," Michael B. Raizman, MD, said during the Irving H. Leopold Lecture at the Wills Eye Institute Alumni Conference. "It's really important to be able to do some [new] things. I would encourage you all to gain experience with some new techniques."
Anterior chamber IOLs are the best option in many, if not most, cases, Dr. Raizman said, because recent designs are safe and can be well tolerated for decades. Precise measurement and sizing are critical.
"Anterior implants have a stigma. I'd like to eliminate that stigma. They should be your friends," Dr. Raizman said. "It's not a sign of failure to use an anterior chamber lens."
However, anterior chamber IOLs should be avoided in cases involving narrow angles, peripheral anterior synechiae, iris defects and corneal endothelial compromise, Dr. Raizman said.
Dislocated and subluxated IOLs require particularly keen diligence, he said.
"The biggest problems occur when you have to deal with an implant that has fallen into the vitreous," he said. "Often we have a chance to intervene before that happens."
Suturing to the sclera or iris may be a suitable alternative in some cases of IOL dislocation, he said.
Surgeons should gain experience with various tools such as McCannell suturing techniques, capsular tension rings and iris/capsule retractors, Dr. Raizman said.
"They're really not that difficult," he said.
- Disclosure: Dr. Raizman has no relevant financial disclosures.