1/7. Piggyback silicone intraocular lenses of opposite power.A patient with high myopia and astigmatism had cataract extraction with implantation of 2 silicone intraocular lenses (IOLs) of opposite power (ie, 1 plus and 1 minus). A Staar AA4203TL toric IOL ( 9.50 diopters [D]/3.50 D) and a Staar AQ5010V additive lens (-3.00 D) were used to correct both the astigmatism and the high myopia. The use of the 2 lenses was necessary because the toric IOL was not available in low dioptric powers. A crystalline interpseudophakos deposit developed after 1 week and resolved after 4 weeks. Three months postoperatively, the patient had an uncorrected visual acuity of 20/25.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/7. Correcting high astigmatism with piggyback toric intraocular lens implantation.An 86-year-old man presented for cataract surgery with corneal astigmatism of 5.12 diopters (D). After cataract extraction with small-incision techniques, 2 toric plate-haptic silicone intraocular lenses (IOLs) were implanted in the capsular bag, each with a 3.50 D cylinder add (2.30 D at the spectacle plane). Six weeks postoperatively, corneal astigmatism was 3.38 D at 70 degrees and refractive astigmatism was 1.00 D at 20 degrees. Uncorrected visual acuity was 20/40. No IOL rotation was observed. Implantation of piggybacked toric lenses may be a viable option for correcting moderate to high astigmatism.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/7. Sutured piggyback toric intraocular lenses to correct high astigmatism.A 74-year-old woman presented for bilateral cataract surgery, which was performed 3 days apart. Corneal astigmatism was 4.25 diopters (D) in the right eye and 4.87 D in the left. After cataract extraction through 6.0 mm scleral incisions, 2 toric, plate-haptic, silicone intraocular lenses (IOLs), each with a 3.50 D cylinder add power (2.30 D at spectacle plane), were sutured together and implanted in the bag. Both eyes had limbal relaxing incisions postoperatively. Four months postoperatively, corneal astigmatism was 4.50 D in the right eye and 4.00 D in the left. Refractive astigmatism was 0.50 D with an uncorrected visual acuity of 20/40 in both eyes. No IOL rotation was observed. Suturing toric lenses together allows greater correction of astigmatism without concern about counter rotation of the lenses.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/7. Accommodative intraocular lens tilting.PURPOSE: To report an unusual complication of accommodative intraocular lens (IOL) implantation after clear lens extraction for hyperopia correction. DESIGN: Observational case report. METHOD: A 48-year-old woman underwent clear lens exchange for the correction of moderate hyperopia. A Crystalens Model AT-45 Accommodating Posterior Chamber IOL (AT-45 IOL) was implanted to allow optimal distance and near vision. At the 3-week follow-up appointment, she complained of monocular diplopia. Ocular examination showed an increased astigmatism, causing decreased visual acuity. Scheimpflug Pentacam Image and Wave Front Analysis supported the diagnosis of IOL tilting. RESULTS: IOL repositioning was unsuccessful because of fibrosis of the haptics. It was necessary to replace AT 45 IOL with a monofocal acrylic sulcus-fixated IOL. CONCLUSION: Control of capsular fibrosis should be a major concern, especially in this type of IOL. Accommodating IOL exchange appears to be a safe alternative to manage this complication.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/7. holmium:YAG laser thermokeratoplasty for correction of astigmatism.The effect of astigmatic holmium:YAG laser thermokeratoplasty in three eyes with previous surgery (extracapsular cataract extraction, penetrating keratoplasty and failed extracapsular cataract extractionntric photorefractive keratectomy 1 to 7 years previously) was evaluated. In the extracapsular cataract extraction eye the effect of a four-spot laser thermokeratoplasty regressed to almost zero within 1 week. In the penetrating keratoplasty and photorefractive keratectomy eyes an eight-spot laser thermokeratoplasty produced an enormous overshoot in astigmatic power of about 15.00 diopters (D), decreasing within 5 months to almost zero in the eye with penetrating keratoplasty and to 4.00 to 5.00 D corneal astigmatic power in the photorefractive keratectomy eye after 8 months of observation.- - - - - - - - - - ranking = 3keywords = extraction (Clic here for more details about this article) |
6/7. corneal topography for intraocular lens power calculations.BACKGROUND: In patients undergoing cataract extraction with PC IOL insertion, pre-op and post-op corneal power measurement is necessary to calculate induced astigmatism. In cases with irregular corneal astigmatism, measurements with traditional keratometry is inaccurate. We report the use of video keratography in three cases that required keratometry readings in order to calculate IOL power. These cases were characterized by irregular or incomplete keratometer mires, so quantitative descriptors derived from computer-assisted corneal topography (TMS-1) were used instead. CONCLUSION: The standard keratometer is useless in cases in which the mires appear irregular or incomplete. In such cases, computer-assisted corneal topography can be used successfully. Recently, a new corneal topography index has been developed, the average corneal power, which is a measure of the average corneal power within the entrance pupil. We are currently evaluating the use of average corneal power to assist in the calculation of IOL powers.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/7. Cataract development after implantation of the Staar Collamer posterior chamber phakic lens.Implantation of a posterior chamber phakic intraocular lens is an effective refractive procedure with a good safety record in the short-term follow-ups reported in the literature. Cataract formation is a potential complication of the procedure. Two patients developed lens opacities in 3 eyes after the procedure was performed for myopic astigmatism. The possible causes are discussed. This is not a dangerous complication as cataract extraction is easily achieved if necessary. However, it is undesirable and further research is required to assess the long-term incidence, causes, and ways to prevent its occurrence.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |