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Alan B. Aker MD
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Alan Aker, MD, presents the case of a 30-year-old male with a dislocated crystalline lens. Dr. Aker starts the case by making a small capsulorhexis and removes the soft lens with irrigation and aspiration. After most of the lens material is removed, the surgeon grasps the edge of capsule with forceps and removes the bag and implants an anterior chamber IOL.
Posted: 7/22/2011
Alan B. Aker MD
Alan Aker, MD, presents the case of a 30-year-old male with a dislocated crystalline lens. Dr. Aker starts the case by making a small capsulorhexis and removes the soft lens with irrigation and aspiration. After most of the lens material is removed, the surgeon grasps the edge of capsule with forceps and removes the bag and implants an anterior chamber IOL.
Posted: 7/22/2011
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Just Now
wu bo
4 years ago
amazay
Them Vu
11 years ago
I have a patient in his 40s with an anterior chamber IOL as a child and his cornea is doing great.
Alan Aker
14 years ago
The questions and comments are very appropriate. As far as the use of a CTR or a sutured CTR, we do these fairly often on our mission cases, but our longterm experience (20+years) with this particular ACIOL has convinced us the corneas do extremely well when the surgery is performed gently and the lens is properly sized and positioned. Jim Gills and Dennis Williams told me about the advantages of this IOL which I believe was designed by Dr. Feaster. It was originally marketed by Storz and today is available from B+L. The patient was not referred to a retinal surgeon primarily because I felt comfortable performing the surgery. In addition there was the issue of cost in a young patient without insurance. Having our own ASC enables us to offer both the services of our surgeons and the ASC for these patients that qualify for our mission cataract program. Suturing to the sclera years ago resulted in late complications such as IOL dislocation and endophthalmitis. Today these may be of less concern, but I personally would worry more about the complications of IOL tilt or dislocation and scleral erosion than about issues with the cornea. As I have said, we have followed numerous of own patients with this particular ACIOL for more than 20 years without any signs of corneal decompensation. Thanks for all your comments. Alan Aker
Paul Chiranand
14 years ago
So why did you go through the whole case and at the end pull out the capsule. Why didn't you put a CTR or a sutured CTR. If you were going to take the whole lens out and put in an ACIOL, why not have a retiina surgeon just do it. They could have done it in 2 minutes.
ari weitzner
14 years ago
the video i was referencing was "cataract surgery with a view" by dr. jones. the case looks almost identical. dr. gumi--the inability to afford the ctr is probably the reason
Mario Zambrano
14 years ago
Bye bye cornea in 10 years. I would have opted for an intrascleral IOL fixation
ari weitzner
14 years ago
i saw a video where a ctr with cionni ring was inserted and sutured to sclera which stabilized the bag nicely, and iol placed in the bag. i suppose a second ctr segment could be inserted and sutured if bag needed more support. in a 30 year old patient, i think that, or suturing the iol to iris or to sclera in sulcus, is a better option than ac iol. in an older patient, the ac iol would be ideal. i am curious why ac iol was chosen in such a young patient, as dr. aker is obviously a very skilled surgeon
Gustavo Rojas
14 years ago
I guess that the patient coudn´t afford it the ctr, but, that´s good question, why not suturing the IOL