Experts at UT Southwes provide terndifferent methods for inserting supplementary intraocular lenses.

Usually, patients who have cataract surgery have an artificial intraocular lens put in place of their natural lens (IOL). But occasionally issues occur that need the implantation of a secondary IOL that presents greater surgical challenges.

According to ophthalmologist Kishan G. Patel, M.D., Assistant Professor in the Department of Ophthalmology at UT Southwestern, there are several approaches available for secondary IOL placement, and each has benefits and drawbacks.

In a recent issue of Retina Today, Dr. Patel—a specialist in complex secondary IOL insertion and retinal surgery—outlined four surgical approaches to the treatment.

In North Texas and beyond, the Ophthalmology Department at UT-Southwestern is a leading supplier of secondary IOLs. With highly skilled surgeons, cutting-edge tools, and the capability for surgeons to collaborate in difficult combined cases when appropriate, the department stands out as a regional and national resource in secondary IOL placement and comparable surgeries.

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Cataracts, a clouding of the usually clear eye lens, commonly appear in elderly persons and eventually cause vision impairment. The first step in treating cataracts is to remove the cataract, then an IOL is inserted. But if the eye does not provide enough support for a conventional IOL, a secondary IOL placement can be required.

Individuals who no longer have their native lens or patients with aphakia, a condition in which there is no lens, offer complications for secondary IOL procedures. In the publication, Dr. Patel and three of his colleagues use written and visual representations to describe surgical advice for surgeons that will help them successfully treat these patients.

The study provides information on surgical techniques to lower the risk of visual impairment brought on by surgery, the most recent IOL models, and more for anterior chamber IOLs, or those inserted in the front chamber of the eye. The sutureless intrascleral fixation technique includes inserting an IOL without using stitches within the sclera, or white layer of the eye. To prevent the IOL from dislocating or moving during this procedure, the authors advise utilizing IOLs constructed of a specific material and performing little surgical manipulation.

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Dr. Patel and colleagues provide advice on the best kinds of sutures to use as well as other methods to enhance outcomes for IOLs that are fixed with stitches on the sclera. They also detail tactics to prevent the IOL from tilting and prevent problems after surgery. IOLs are attached to the iris, the colorful portion of the eye, using the final method for placement. The authors specify the stitch and knot to utilize for this surgery and describe the movement to be used to stabilize the IOL.

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