April 21, 2017 Conference
IOL Dislocation—Exchange Techniques
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Dr. Peter A. Rapoza, Ophthalmic Consultants of Boston (Presenter)
Speaker Session Topic
Evaluation of the zonular/capsular apparatus is paramount. Imaging may include specular microscopy, anterior segment or retinal OCT. With an intact anterior capsular annulus, a 3- piece PC-IOL may be held in the sulcus by capsular remnants. If a defect or radial tear extending through the equator is present, sulcus fixation can be achieved by fixating a haptic of the IOL to the iris or sulcus. In the absence of capsular support, surgeons can consider an AC-IOL, a 3 piece PC-IOL fixated to the iris or sulcus or a PMMA PC-IOL fixated to the sulcus. Prolene sutures can be placed in a McCannel fashion for haptic fixation to the iris. Prolene or Gore-Tex can anchor haptics of a 3 piece or PMMA PC-IOL to the sulcus. Alternatively, a scleral tunnel can hold the haptics of a 3 piece PC-IOL. Surgeons should be adept at pars plana vitrectomy for anterior segment surgery.