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Nicole Fram, MD
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This video depicts challenges removing a treated LAL IOL. The treated LAL is very brittle and can crumble when grasped with most 23GA microsurgical serrated forceps. In the beginning of the video, a treated LAL is grabbed with 23GA serrated forceps and the brittle lens breaks into pieces as it is cut with 19GA non serrated scissors.
Next, a new treated LAL is replaced in the SimulEYE and the 18GA Snyder Osher serrated scissors are used to cut the treated LAL more easily in 1-2 cuts. Note that the serrated scissors hold while they cut and there is little to no compression with the 23GA forceps in this portion of the video. Ideally, there should be no grasping of the treated IOL with the forceps and a Sinskey or Kuglan hook should be used for countertraction. Incision size should also be enlarged to 3.5mm as the IOL is silicone and thick. Fortunately, removing treated LAL’s are far less common since the development of the Activeshield coating on the LAL IOL.
Posted: 1/30/2023
Nicole Fram, MD
This video depicts challenges removing a treated LAL IOL. The treated LAL is very brittle and can crumble when grasped with most 23GA microsurgical serrated forceps. In the beginning of the video, a treated LAL is grabbed with 23GA serrated forceps and the brittle lens breaks into pieces as it is cut with 19GA non serrated scissors.
Next, a new treated LAL is replaced in the SimulEYE and the 18GA Snyder Osher serrated scissors are used to cut the treated LAL more easily in 1-2 cuts. Note that the serrated scissors hold while they cut and there is little to no compression with the 23GA forceps in this portion of the video. Ideally, there should be no grasping of the treated IOL with the forceps and a Sinskey or Kuglan hook should be used for countertraction. Incision size should also be enlarged to 3.5mm as the IOL is silicone and thick. Fortunately, removing treated LAL’s are far less common since the development of the Activeshield coating on the LAL IOL.
Posted: 1/30/2023
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