SEP 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/176967

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September 2013 Dr. Ventura and colleagues analyzed 17 eyes of 10 patients with congenital lens subluxation. "The surgical technique consisted of phacoaspiration with implant of an endocapsular ring and intraocular lens with one loop haptic amputated," Dr. Ventura, a corresponding author, stated in his Portuguese-language article, "Congenital lens subluxation: visual acuity outcomes and intraocular lens postoperative position," published in Arquivos Brasileiros de Oftalmologia in 2010. Dr. Ventura explained that IOL implantation with one loop haptic amputated worked in these cases because the amputation allowed the lens' optic to be aligned with the patients visual axis, and the stub of the amputated haptic helped maintained the IOL's position, while the endocapsular ring expanded the capsular bag in all its circumference. With this technique, it is possible to maintain the integrity of the capsular bag, while avoiding zonular tension, he said. "There was a VA improvement in 17 (100%) eyes: in 12 eyes (70.6%) the visual acuity was better than 20/40; 4 (23.5%) ranged from 20/40 to 20/100, and 1 (5.9%) had visual acuity worse than 20/100, however better than the preoperative visual acuity," according to Dr. Ventura. Posterior capsular opacification (PCO) did occur in 10 eyes (58.9%). "Ultrasound biomicroscopy showed that all IOLs were partially decentralized, however without surpassing the pupil border limit," Dr. Ventura reported. "Endocapsular ring position was correct and there was a good capsular support in all cases." Dr. Ventura concluded that "the evaluated surgical treatment provided good intraocular lens and endocapsular ring position, with VA improvement. Thus, this technique is a viable, effective, and safe option for the visual rehabilitation of patients with congenital lens subluxation." While no medical device company would ever recommend cutting their cartridge or amputating the haptic of their IOL on purpose, such measures have benefitted surgeons and their patients in different parts of the world. Whether it's cutting a cartridge to remove a haptic—or cutting a haptic to help align the lens' optic and restore visual function—surgeons strive for the best visual health of their patients, even in unusual ways. EW Editors' note: Drs. Prasad and Ventura have no financial interests related to this article. EW International Contact information Prasad: +91 9431209747, ddeyecentre@gmail.com Ventura: +55-81-3302-2020, marcelovhope@gmail.com 73

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