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In general, it is fairly easy even after several years to explant hydrophilic IOLs when the capsular bag is intact. I am very familiar with IOL explantation, especially of hydrophilic IOLs because these cases are frequently referred to me. Eyes that receive a hydrophilic IOL often develop posterior capsular opacification (PCO) earlier than eyes that receive IOLs manufactured out of other materials, but surgeons also frequently mistake IOL opacification for PCO.
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The design of the Oculentis MF series includes closed-loop haptics in which lens epithelial cells can grow, thereby strongly fixating the lens in the capsular bag.
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2: How to explant an IOL that has been in the capsular bag for several years. 1: How to replace the explanted IOL and still provide multifocality or depth of focus comparable to that on the unaffected side. 2,3Īfter bilateral implantation, it is not unusual for only one multifocal IOL to become opacified, but this patient’s situation poses three main challenges. 1 There is a difference between primary calcification caused by the manufacturing process and secondary calcification caused by additional external parameters such as air/gas exposure to the hydrophilic IOL during Descemet membrane endothelial keratoplasty or pars plana vitrectomy with air/gas tamponade. Apple International Laboratory of Ocular Pathology, my colleagues and I reported that IOL calcification is by far the most frequent reason for IOL explantation. The German regulatory body has issued several safety advisories on this matter. Calcification of hydrophilic acrylic IOLs, this lens model in particular, have been reported frequently. How would you proceed? If you would perform an IOL exchange, what style of lens would you choose as a replacement and why? Are there any special concerns you have about this case?Ĭases similar to this one are not unusual in Germany. Calcification of the IOL in the left eye was evident. The IOL in the right eye was clear, but the IOL in the left eye was cloudy from calcification of its surface (Figure).įigure. Upon examination, UDVA was 20/20 OD and 20/50 OS. One year after the capsulotomy, the patient returned to the clinic and reported decreased visual acuity in the left eye. Two years after surgery, the patient underwent an Nd:YAG laser capsulotomy in the left eye by another surgeon. Three months after surgery, uncorrected distance visual acuity (UDVA) was 20/25 OU, BCVA was 20/25 OD and 20/20 OS, and uncorrected near visual acuity was 20/32 OD and 20/25 OS. This IOL is made of a hydrophilic acrylic and has a hydrophobic surface. I recommended this lens because I find that patients typically experience little in the way of postoperative dysphotopsias with it and achieve good reading vision with its 3.00 D add.
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He expressed a desire to be free of glasses after surgery.Ĭataract surgery with the implantation of a Lentis MPlus X IOL (Oculentis) was performed on each eye. He used a computer and mobile phone and enjoyed reading magazines and newspapers.
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BCVA was 20/50 OD with a manifest refraction of -0.25 -0.5 x 117º and 20/32 OS with a manifest refraction of -0.50 D.Īlthough retired, the patient had an active lifestyle that included regular games of golf, driving during the day and at night, and taking cruises. An examination found bilateral cataracts. The patient reported a bilateral reduction in visual acuity that was worse in the right eye. Integrating DURYSTA (bimatoprost intracameral implant) Into Your Practice: Insights From ColleaguesĪn 85-year-old man presented for a cataract surgery evaluation. The Vivity Extended Depth of Focus IOL: Our Clinical Experience Vivity Extended Vision IOL: Expanding Patient Selection for Premium Lens Options Listen, Look, Act: Making Sense of the Emerging Science in Dry Eye Disease Say Anything: CRST Readers Share Their Preferences for Refractive Correction and Enhancements After Cataract Surgery Optimizing Outcomes When the Target Is Low MyopiaĬorrecting Astigmatism During Cataract SurgeryĪllograft Corneal and Biosynthetic Inlay Implantation in PresbyopiaĪn Allograft or Biosynthetic Corneal Rings? Ocular Surface Disease and Refractive Measurements
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