EW
FEATURE
57
worse," Dr. Condon said.
Dr. Ahmed said he regularly
implants premium lenses in PXF
patients with zonulopathy or pha-
codonesis.
"I have no problem, as long as
I've supported the bag sufficiently,"
he said. "For example, in someone
who has loose zonules, if I'm going
to use a toric or multifocal, I would
look
at using a capsular tension seg-
ment and suturing the bag in place.
If I didn't do that, I'd be very con-
cerned about a multifocal or toric
lens because of concerns about mis-
alignment."
Dr. Hart said he takes a more
conservative approach. "If there is
pre-operative
phacodonesis, I think
that premium IOLs are contraindi-
cated," he said.
Prostaglandin usage
Dr. Condon said he does not stop
prostaglandin use in patients who
are already taking the drug for glau-
coma, especially those with moder-
ate disease that may be somewhat
precariously controlled.
"I will supplement their pre-
and post-operative management
with a non-steroidal anti-inflamma-
tory agent, which is less likely to
result in the prostaglandin having
unwanted
side effects such as cys-
toid macular edema," Dr. Condon
said.
Dr. Ahmed agreed and said he
doesn't stop prostaglandin use ei-
ther.
"Non-steroidals mitigate the
risk of CME, and I like having the
prostaglandins
on board to deal with
potential IOP spikes after cataract
surgery," he said.
EW
Editors' note: Dr. Ahmed has financial
interests with AMO. Dr. Condon has
financial interests with Alcon (Fort
Worth, Texas). Dr. Hart has no finan-
cial interests related to his comments.
Contact information
Ahmed: 416-625 3937,
ike.ahmed@utoronto.ca
Condon: garrycondon@gmail.com
Hart: 248-855-1020, j.c.hartjr@sbcglobal.net
February 2011
September 2011 Challenging cataract cases
"Working with Marco field specialists and product managers has made my purchase of my OPD a wonderful experience–
and has provided us with the depth of support we greatly appreciate. The instrument is an invaluable tool for any surgeon
utilizing aspheric/wavefront technology...and in the premium IOL market the OPD allows me to refine
my coupling process of lens to patient–to maximize satisfaction."
—Jonathan D. Solomon, MD/Bowie, Maryland
Make your best choice @ www.whosincontrol.info.
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272-OPD-Lenses-EW H-half_1-2 horiz-EW 4C 8/9/11 7:39 PM Page 1
Early CTR placement. Placing the ring early can cause future complications
Source: Iqbal (Ike) K. Ahmed, M.D
