Article
The technique of IOL fragmentation for its exchange
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Authors
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Oleg Fechin
- IRTC Eye Microsurgery Ekaterinburg Center, Ekaterinburg, Russland
| Published: | May 14, 2019 |
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Outline
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Purpose: Although rarely, ophthalmic surgeons have a necessity to remove an IOL from the eye. This happens in case of implant rejection (chronic iridocyclitis and parsplanitis, including systemic diseases), need for IOL exchange in case of IOL opacification or refractive error. Tre removed IOL is moved with instrument (microhooks) from the posterior chamber to the anterior and then fragmented. Standard technique of IOL fragmentation includes, as a rule, dissection of the optic part in 2 to 4 parts with scissors for IOL removal through as small incision as possible, as a rule, incision width is 3.5 – 5.0 mm.
Aim: To suggest an effective technique of IOL fragmentation for its removal from the eye with the aim of simplifying manipulations, reducing operation trauma and shortening operation time.
Methods: A 3.5 – 3.75 mm tunnel self-sealing incision and an 1.0 mm paracentesis are formed. The anterior chamber is filled with viscoelastic. The removed IOL is moved with instruments (microhooks) from the posterior chamber to the anterior. Then the IOL is grasped and fixed with a collet forceps through the paracentesis. Through the main incision the IOL optic part is fragmented with collet scissors not completely but a little bit beyond the middle. One of the halves is grasped with second collet forceps and evacuated through the main incision by a rotation movement.
Results: Eleven operations or flexible IOLs removal through 3.5 – 3.75 mm incisions have been performed in patients aged from 47 to 82 years. The IOLs were Hanita B-lens – 2, Hanita C-lens -2, C-Flex Rayner -1, Acrysof Natural - 3, Acrysof IQ -1, B&L MI-60 -1, an unknown model -1.Operation time was shortened. No complications were marked.
Conclusions: The suggested technique simplifies and minimizes manipulations in the eye. Time of manipulations during IOL fragmentation is shortened. Thus, operation trauma during IOL removal through a minimal incision is reduced, quick rehabilitation is achieved. This technique is actual for cases of implant rejection (chronic iridocyclitis, parsplanitis), IOL exchange for IOL opacification or refractive errors.
Financial Disclosure: The author has no financial interest.
