Management Of Dislocated IOL-Capsular Bag Complex And Glaucoma In Pseudoexfoliation Syndrome
Steven Vold, MD, presents the management of dislocated IOL-Capsular Bag Complex and glaucoma in pseudoexfoliation syndrome. The surgeon removes the lens material with a vitrectomy unit and secures the posterior chamber IOL to the iris. Endoscopic Cyclophotocoagulation (ECP) is performed to control intraocular pressure.
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Comments (3)
Did one today, but found it tough to get both haptics into the posterior chamber for suturing without the optic following. Doing one at a time solved the problem.
Using a pars plana approach, the risk of losing the IOL posteriorly is minimized. In my experience, iris-fixated IOLs tend to do well over time. However, if a suture were to break and/or a haptic come loose over time, placing an additional suture would obviously be warranted. Placement of an ACIOL would certainly have been reasonable here. However, this technique is not without risk in a 90 year-old glaucoma patient. Furthermore, visual rehabilitation tends to be more rapid in my hands when using a small incision surgical technique. Hope this helps.
What would have happened it the IOL fell posteriorly? What is the longevity of the iris sutures? I have seen posterior sutures fail after several years requiring another procedure.