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ASCRS/ESCRS Survey on Foldable IOLs Requiring Explantation or Secondary Intervention 2005 Update

ASCRS/ESCRS Survey on Foldable IOLs Requiring Explantation or Secondary Intervention 2005 Update. Nick Mamalis, MD Professor of Ophthalmology. John A. Moran Eye Center University of Utah, Salt Lake City. Co-Authors Brian Haugen, MD Jonathan Haymore, MD Natalya Romaniv, MD

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ASCRS/ESCRS Survey on Foldable IOLs Requiring Explantation or Secondary Intervention 2005 Update

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  1. ASCRS/ESCRS Survey on Foldable IOLs Requiring Explantation or Secondary Intervention 2005 Update

  2. Nick Mamalis, MDProfessor of Ophthalmology John A. Moran Eye Center University of Utah, Salt Lake City

  3. Co-Authors Brian Haugen, MD Jonathan Haymore, MD Natalya Romaniv, MD Ophthalmic Research Fellows

  4. Materials and Methods • 8th annual survey of ASCRS/ESCRS members • Foldable IOL complications/explantations - 2005 • Intermountain Ocular Research Center - University of Utah • Cataract Clinical Committee

  5. Materials and Methods • Signs and symptoms/complaints • Pre-op visual acuity • Complications requiring IOL removal/exchange/secondary intervention

  6. Materials and MethodsFoldable IOL Designs • One-piece, plate-type lenses • One-piece lenses with haptics • Three-piece lenses • Multifocal lenses

  7. Materials and MethodsFoldable IOL Materials • Silicone • Acrylic (hydrophobic) • Hydrogel (hydrophilic acrylic) • Collamer

  8. Survey Lens Totals 2005

  9. ComplicationsThree-Piece Silicone IOL • Dislocation / decentration seen most commonly

  10. ComplicationsOne-Piece (Plate Silicone) • Dislocation / decentration

  11. ComplicationsThree-Piece Acrylic • Dislocation / decentration • Incorrect lens power • Glare/optical aberrations

  12. ComplicationsOne-Piece with Haptics Acrylic • Incorrect lens power • Dislocation / decentration

  13. ComplicationsThree-Piece Hydrogel • Calcification / opacification • Damaged IOL

  14. ComplicationsOne-Piece with Haptics Hydrogel • Calcification / opacification

  15. ComplicationsMultifocal Silicone • Glare / optical aberrations • Incorrect lens power

  16. Pre-operative Visual Acuity2005

  17. Post Explant Visual Acuity2005

  18. DiscussionFoldable IOL Complications • Dislocation/decentration overall most common reason for IOL explantation • Followed by incorrect lens power • Damaged IOL

  19. DiscussionFoldable IOL Complications • Continuing trends in complications over eight years • Several differences in complications over this period of time

  20. Three-Piece, Silicone

  21. Three-Piece, Acrylic

  22. One-Piece (Plate) Silicone

  23. DiscussionFoldable IOL Complications • Calcification of hydrophilic acrylic (hydrogel) IOLs the next most common reason for explantation • Calcification on both the lens surface as well as substance of the lens

  24. DiscussionFoldable IOL Complications • Glare/optical aberration continues to be seen as a reason for IOL removal • Other reasons such as damaged IOL during insertion seen less frequently

  25. ConclusionsAvoidance of Complications Using Foldable IOLs • Good surgical technique essential • CCC with capsular bag fixation of the IOL

  26. ConclusionsAvoidance of Complications UsingFoldable IOLs • Need for accurate IOL measurements • Necessity for use of new technologies for axial length measurements and calculations

  27. ConclusionsAvoidance of Complications UsingFoldable IOLs • Ongoing vigilance regarding newer IOL materials • Hydrophilic acrylic (hydrogel) IOLs

  28. ConclusionsASCRS/ESCRS Survey • Ongoing yearly data collection • Forms available by ASCRS/ESCRS fax on demand-web site • Please submit survey forms on explanted foldable IOLs

  29. Thank You

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