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Abstract #19217 Published in IGR 3-1
Lens implant selection with absence of capsular support
Dick HB; Augustin AJCurrent Opinions in Ophthalmology 2001; 12: 47-57
If contact lens or spectacle correction is not viable, there is little information to show that the secondary placement of an intraocular lens (IOL) is the method of choice in the absence of capsular support. The choice of IOL mainly depends on the preoperative status of the eye (e.g., aphakia in children) and the selected location for the implant. Theoretically, there are several IOL implantation approaches in cases without capsular support: angle-supported anterior chamber (AC) IOL, iris-fixated AC IOL, iris-sutured or iris-fixated posterior chamber (PC) IOL, and transsclerally sutured PC IOL. However, no consensus exists on the indications or on the relative safety and efficacy of these different options. Implantation of modern AC IOLs, such as refined open-loop or iris-fixated claw (toric) AC IOLs, has regained popularity and provides a valuable alternative to sutured PC IOLs. However, in the absence of capsular support, transsclerally sutured PC IOLs offer numerous advantages in certain eyes. Because of their anatomical location, sutured PC IOLs are more appropriate for eyes with compromised cornea, peripheral anterior synechiae, shallow anterior chambers, or glaucoma. Moreover, sutured PC IOLs are appropriate if the patient with aphakia is young or has a life expectancy of ten years or more. Recent technological advances, including PC IOLs with iris diaphragms for aniridia, toric AC IOLs, and small-incision surgery with foldable, transsclerally sutured IOLs, would appear to improve clinical outcomes further.
Dr H.B. Dick, Department of Ophthalmology, Johannes-Gutenberg-University, Langenbeckstrasse 1, 55131 Mainz, Germany. bdick@mail.uni-mainz.de
Classification:
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
