Alcon expand series iol

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The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. All of these lenses were reoriented surgically.

This article shares our experience with the AcrySof Toric IOL and our method of reorienting the lens in the rare instances when it rotates off axis. All of the lenses could be seen to have rotated clockwise, starting from a vertically oriented axis. This observation may demonstrate that gravity combined with ocular movement can propel a vertically oriented IOL off axis within several days of surgery such that the lens comes to rest in an oblique or horizontal position Table 1.

We have used three surgical strategies for reorienting the IOL 2 to 8 weeks after the initial surgery in 12 of the 13 cases of misalignment. The CPT code used for surgery was repositioning IOL, secondary procedure, with the 78 modifier applicable for reoperations that occurred within the day postoperative period. Method No. As the anterior chamber became shallow, he injected BSS through one of the paracentesis incisions via a gauge cannula on a 5-mL syringe.

The steps were serial ie, hook rotation, BSS, hook rotation, etc. This was probably the most difficult of the three techniques to accomplish. The technique was employed owing to concern that the introduction of an ophthalmic viscosurgical device OVD might contribute to recurrent postoperative rotation of the IOL. This technique is similar to one described by Dr. This technique was easier than the alternating infusion-rotation method and retained the advantages of not opening the primary incision and not introducing an OVD.

Davison and one for Dr. This was the easiest of the three surgical methods, but it had the disadvantages of opening the primary incision and requiring an OVD. We used a cohesive OVD to ensure its complete evacuation at the end of the case. The IOLs remained aligned in six cases, with the patients achieving their anticipated visual recovery. The patients were satisfied, however, so no additional surgery was performed. We have concluded that, even with an overall length of In our experience, patients can usually tolerate waiting 2 to 3 weeks after the original surgery before secondary intervention, so that latency seems reasonable.

There may be an increased risk of recurrent misalignment if an OVD is used during reorientation surgery. We speculate that it may be helpful to create a slightly extended incisional shelf in myopic eyes in order to avoid overinflation of the globe and capsular bag when we seal the incisions at the conclusion of surgery. Despite rare instances of postoperative axial misalignment, we continue to be enthusiastic users of AcrySof Toric IOLs, because they provide great overall visual improvement to our patients with keratometric astigmatism.

We explain that reorientation surgery is sometimes needed to provide optimal results. James A.

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