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BLOG: Three things every anterior segment surgeon should know about glued IOLs
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In our cover story, we discuss the evolution of the glued IOL procedure, described by Amar Agarwal. I recently performed my first procedure, and both the patient and I have been extremely pleased with the results. Here are my three takeaways from learning and performing this new procedure.
1. This is a very learnable procedure.
It calls upon skills of making a scleral pocket that many of us are old enough to be comfortable with from the days of early phaco surgery. Of maybe greatest importance is orienting the two sclerotomies 180° apart. This directly influences centration and, when done well, helps everything else to fall into place.
2. It takes less time than you think.
When Amar shows his outstanding videos, I always ask myself, “Sure, he makes that look easy, but can I actually do that?” Not only are the steps in this procedure straightforward, but the whole process will take less than 30 minutes for less uncomplicated patients. Again, we owe the approachability of this procedure to Amar’s continuous efforts to simplify the teaching and the steps.
3. It refreshes skills that are worth keeping fresh.
I hesitated to start this procedure because I rarely do vitrectomy from a posterior approach, make scleral pockets or manipulate a lens in the posterior chamber without capsular support. Developing and keeping these skills fresh prepare us as surgeons for unexpected complications in routine cases and broaden our repertoire of comfort in the operating room.
I will be forever grateful to my teachers in this procedure, Amar Agarwal, Soosan Jacob, Eric Donnenfeld, Frank Price, George Beiko and others, for sharing their wisdom and helping me adopt a procedure that will benefit my patients. In my surgical armamentarium, glued IOLs are here to stay.