it's best if the lens explantation is
done relatively quickly after the
original procedure. "Either the next
day or within a week is the most
ideal," Dr. Park said. If it's a few
months out, you have to make sure
that you can still dissect the lens
away. "If you're years out that
becomes a little more problematic,
although it can still be done," she
said.
Dr. Hoffman agreed that the
sooner the lens is explanted, the
easier this is likely to be. However,
he has explanted lenses years later.
"I've explanted a lens seven years
out from the original surgery," he
said. "It's amazing how easy it is to
viscodissect a capsular bag open,
especially if there is a silicone lens,"
he said, adding these tend to stick
less to the bag. It may, however, be a
little harder in long-term cases to
find an opening to the bag.
"Some surgeons will use a
30-gauge needle to get between the
capsule and the lens to get the vis-
codissection started," Dr. Hoffman
said. He pointed out that some
LASIK cannulas have a very thin
spatulated end, which can be placed
under the capsule and used to sepa-
rate it from the optic. He views this
as the hardest part. "Once you get
that first part of the capsule opened,
Pseudophakic dysphotopsia April 2014
In this trauma case, the whole IOL in the bag went into the anterior chamber, requiring
explantation.
A decentered lens, which may require explantation.
Source (all): Richard Hoffman, MD
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