Since ridley implanted
the first intraocular lens following cataract
surgery 50 years ago, the evolution in IOL materials,
designs and implantation techniques has vastly
improved surgical outcomes. Today, patients expect
and achieve excellent postoperative vision largely
due to contemporary clear corneal phacoemulsification
cataract surgery and advances in foldable IOL
technology.
Silicone and acrylic lOLs are the most popular foldable lenses in the United
States, partly because they can be implanted through 2.8- to 3.2-mm incisions.
We have shown recently (outside the United States) that cataract surgery and
intraocular lens implantation is possible, in selected patients, through sub-2-mm
incisions using laser cataract emulsification.* Most contemporary fold-
able lOLs have 5-6-mm optics and a total diameter between 12 and 13.5mm.
Although these designs provide
relatively good in-the-bag stability and centration,
pre-, intra- and post-operative management is
not problem-free. In this article, I will address
steps that cata- ract surgeons can take to minimize
the complications associated with intraocular
lenses.
*Kanellopoulos AJ, et al.
Dodick photolysis for cataract surgery.
Early experience with the Q- switched Nd:YAG
laser in 100 consecutive patients. Ophthal
1999; 106:2197-2202.
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IOL
subluxations, known as sunrise
(top)
and sunset (below). |
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