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Michael Patterson, DO
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This case poses numerous challenges when a patient presents to Michael Patterson, DO, with a decentered multifocal. Shortly after the procedure is started it is realized the posterior capsule was absent and the lens had been placed in the sulcus previously. The patient only wanted a premium lens and we do not have a great option of a 3 piece multifocal. Decision was made to explant the existing lens, and suture fixate using a cow-hitch or girth-hitch fixation technique on the haptics. The lens was able to be centered nicely with this approach.
Posted: 1/19/2017
Michael Patterson, DO
This case poses numerous challenges when a patient presents to Michael Patterson, DO, with a decentered multifocal. Shortly after the procedure is started it is realized the posterior capsule was absent and the lens had been placed in the sulcus previously. The patient only wanted a premium lens and we do not have a great option of a 3 piece multifocal. Decision was made to explant the existing lens, and suture fixate using a cow-hitch or girth-hitch fixation technique on the haptics. The lens was able to be centered nicely with this approach.
Posted: 1/19/2017
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Just Now
Michael Patterson
8 years ago
No multifocal available, and he has most certainly done amazing with only 1 suture remaining. He does not have much cylinder at all at this point. Will keep you posted.
ari weitzner
8 years ago
opening the eye so widely will likely reduce the effect of the mulifocal due to cylinder. did you not cut the lens since another multifocal was not available?
Anonymous
8 years ago
So, you are leaving a gortex knot in the scleral surface. Is that well tolerated long term. Is there risk of erosion through the conj. as prolene would be expected to? I ask because I do a similar technique that buries the knot intrascleral. I wonder if that is unnecessary
Michael Patterson
8 years ago
I almost always bury the knots. In this case it caused my lens to decenter. As you can see I buried 1 of the 2 knots. I think it is well tolerated as gortex is similar in reaction to tubes like Ahmed valves and the like. Time will tell but so far no problems noted