Professional Documents
Culture Documents
Introduction
Introduction
Purpose:
to asses the efficacy and safety of
implanting a secondary IOL (newly
introduced IOL designed) in the ciliary
sulcus to correct pseudophakic
ametropia
Methods
Setting:
Depart of Ophthalmology, Medical Univ of
Vienna, Vienna, Austria
Prospective nonrandomized study
Patients:
patients who had implantation of a
secondary IOL (Sulcoflex 653L) to correct
residual refractive error after phaco with IOL
implantation in capsular bag
Methods
Preop assessment:
UDVA, CDVA, tonometry, funduscopy,
biometry (IOL Master, Carl Zeiss Meditec), the
power of the secondary IOL (Haigis formula)
Surgical technique
the 2ndary IOL was implanted in the ciliary
sulcus using supplied 1-piece single use
injector
Methods
IOL
- a foldable
aspheric,
- 1-piece hydrophilic
acrylic,
- 13.5 mm,
- 6.5 mm optic,
-concave posterior
surface
Methods
Evaluation:
- visual & refractive outcomes
- inflammation
laser flare-cell meter
- the position and rotation of the IOLs
- Scheimpflug images
Postoperative follow-up : 1 week,
1,6,12, and 17 months
Result
12 eyes of 10
patients
Mean spherical
equivalent
-1.25D0.25 to 0.250.40
UDVA
Mean Snellen:
0.90.1
Result
All surgeries
uneventful
Follow-up
- no signs of pigment dispersion, iris bulging,
foreign-body giant cell formation, or ILO
- 1 decentration of the 2ndary lens <0.5mm
- no cases of IOL rotation or tilt
- the Scheimpflug images
the same IOL
lens distancees at all postoperative visits
Result
Result
Result
Laser flare
There was no
significant
difference
between preop &
postop
Discussion
Discussion
Scheimpflug photography
to evaluate the distance between the optics of 2
IOLs
showed:
- well-centered IOL except in 1 case (AL:
31.53mm)
caused by the eyes large ciliary
diameter and weak zonular support
- the distance was always good in the optic
zone
- concave design of the 2ndary IOL prevented
contact between and distortion of the optical zone
Discussion
Discussion
Rotational instability
optical distortion & ciliary body irritation
Undulating haptic
preserve IOL stability
& reduce the risk for IOL rotation
Elevated IOP
1 eye had a rise in IOP
OVD postop
Pupil capture
no cases
2ndary IOL has a large optic
(6.5 mm) + 10 degrees posterior haptic
angulation
Discussion
Conclusions
Haigis formula:
d = the effective lens position, where ...
d = a0 + (a1 * ACD) + (a2 * AL)
ACD is the measured anterior chamber depth of the eye
(corneal vertex to the anterior lens capsule), and ...
AL is the axial length of the eye; the distance from the cornea
vertex, to the vitreoretinal interface. *
The a0 constant basically moves the power prediction curve up,
or down, in much the same way that the A-constant, Surgeon
Factor, or ACD does for the Holladay 1, Holladay 2, Hoffer Q
and SRK/T formulas.
* The a1 constant is tied to the measured anterior chamber
depth.
* The a2 constant is tied to the measured axial length.