This article is more than 5 years old. Information may no longer be current.
Surgeon: Better to rescue subluxated IOLs than to replace them
Click Here to Manage Email Alerts
BARCELONA — IOL subluxation or dislocation occurs with increasing frequency, as reported in several sessions of the European Society of Cataract and Refractive Surgeons meeting. The best way to deal with this complication may be to rescue the IOL rather than explant it, according to one surgeon.
“I wouldn’t call it an epidemic, but for sure it is something we see more and more often. One of the reasons might be that we do more complicated cases. We dare more and implant IOLs in an increasing number of increasingly old people,” Ehud Assia, MD, said.
Ehud Assia
One approach when this complication occurs is to explant the lens and deal with aphakia by implanting an anterior or posterior chamber lens, secured to the iris or sclera.
“The other option, which I personally advocate, is to reposition the same lens because it is still good optically and because it is already inside the eye. Why take it out? Why make a large incision, manipulate, cut, remove, put the endothelium at risk, and then deal with aphakia and implant another IOL in the eye?” Assia said.
He suggested a number of techniques to rescue and reposition the lens, using a needle and 9-0 Prolene sutures. If the lens is out of the bag, it is best secured to the iris; if it is in the bag, it should be secured to the sclera, he said.
“You can make ring sutures around the haptics or even go through the material itself, through the haptics, the haptic junctions or even through the optic. If there is no concern about the axis of the IOL, you can fixate it in any direction, using multiple sutures,” he said.
Another technique entails the use of the Capsular Anchor (Hanita Lenses), a tool developed by Assia. – by Michela Cimberle
Disclosure: Assia reports he is a consultant to Hanita Lenses and inventor of the Capsular Anchor.