September 28, 2018 - HYNES - Physicians Conference
The loose phakic or pseudophakic lens can be challenging for any anterior segment surgeon to manage. The evaluation and management options are continuously evolving. This video-based presentation will address the clinical thought process with the assessment of these patients, followed by surgical pearls to stabilize an intraocular lens (IOL) in these eyes. Surgical planning and strategy with careful pre-operative planning are imperative. Intraoperative stabilization of the phakic lens may be required to safely perform extraction of the cataract, and capsule tension segments or hooks can be utilized. The loose or dislocated pseudophakic lens also has special considerations, including scleral-fixation of the existing lens or potential IOL exchange. Various options exist to stabilize an IOL, and include one or a combination of the following: capsular tension devices (standard rings, Cionni variant, Ahmed segment), scleral fixation techniques (suture, glue, flanged instrascleral Yamane), and iris-suture fixation of the IOL.