EW CATARACT
43
September 2016
Contact information
Ahmed: ike.ahmed@utoronto.ca
Gorovoy: blehet@gorovoyeye.com
Jones: jasonjonesmd@mac.com
McKee: mckee@swhec.org
Ouano: ouanod@earthlink.net
Safran: safran12@comcast.net
Snyder: msnyder@cincinnatieye.com
approach depends on the surgeon's
preference and experience and the
patient's unique presentation with
the goal of avoiding risk and of
providing stable long-term fixation.
I think that while incision size is a
factor to consider, it is not the most
important issue, and in this case a
large incision was actually used to
provide a refractive advantage for
the patient. Good wound construc-
tion and placement can minimize
the deleterious effect of having a
larger incision, and the long-term
stability and optical advantage of a
large one-piece PMMA 7 mm lens
supported by CV-8 GORE-TEX in a
large, highly myopic eye is hard to
beat. EW
Reference
1. Snyder ME, et al. Tiltless and centration
adjustable scleral-sutured posterior chamber
intraocular lens. J Cataract Refract Surg.
2014;40:1579–83.
Editors' note: The physicians have
no financial interests related to their
comments.
peripheral iridotomy to prevent
reverse pupillary block.
This case highlights that we
have many techniques that can be
used to manage a dislocated lens
IOL complex and little absolute
agreement even among experts
on which approach is best for any
given patient. I think that the best
The lens will move/rotate slightly as
you do this but will not tilt.
The patient ended up with a
refraction of –0.25–0.5 X 100 with a
reduction of his keratometric astig-
matism as seen in the topography
in Figure 3. Figure 4 shows the slit
lamp appearance at 1 week postop-
erative. Note the presence of a nasal
"
This case highlights that we
have many techniques that can be
used to manage a dislocated lens
IOL complex and little absolute
agreement even among experts
on which approach is best for
any given patient.
"
–Steven Safran, MD
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