Eyeworld

161 October 2016 EW MEETING REPORTER patient's situation, could include LASIK, AKs, LRIs, IOL rotation, or IOL exchange. Editors' note: Drs. Raju, Rubenstein, Lin, and Zavodni have no financial interests related to their comments. Dr. Garg has financial interests with Abbott Medical Optics (Abbott Park, Illinois), Allergan (Dublin), and Alcon (Fort Worth, Texas). IOL exchange with the femtosecond laser A session discussed management options for postoperative refractive surprise. Richard Davidson, MD, Denver, described a case where he utilized the femtosecond laser for IOL exchange. The patient was a 51-year-old who had a Crystalens (Bausch + Lomb, Bridgewater, New Jersey) placed prior. Dr. Davidson saw the patient at about 10 months post-surgery, with pain and blurred vision. After doing a UBM, it was evi- dent that the optic of the lens was way in the back of the eye, he said, and was pushing the IOL posteriorly. An OCT was done and proved to be problematic. After discussing the case with retina colleagues, Dr. Davidson said he decided to exchange the lens. The lens was not in the right posi- tion, the bag and optic were in the back, and the patient had phimosis. When doing lens exchanges, Dr. Davidson said he tries to save the bag as much as possible. Fortunately, he had just seen a femtosecond laser used for IOL exchange a couple of weeks prior to this case. For this patient, Dr. Davidson said the femtosecond laser portion went well, but there were still parts of the lens that the laser couldn't cut, particularly areas of dense scarring. He had to cut areas that the laser couldn't cut but was able to proceed with the lens exchange. Microforceps are helpful to get trac- tion on capsule, he added. A Crystalens lens exchange can be challenging, Dr. Davidson noted, because it's hard to get the entire lens out of the bag. He suggested going for the optic first and cutting it out along the hinges. He added that he usually leaves the haptics in the bag for lens exchanges with Crystalens. Despite a successful IOL ex- change, Dr. Davidson said that it took about a year and visits to a retina specialist for the patient to achieve corrected 20/25 vision. SINGLE USE 16 % OFF volk.com /volk1 BUY IN BULK TODAY up to > Trusted Quality of Volk Optics > No More Reprocessing > Sterile Packaged in Boxes of 10 3-Mirror & 4-Mirror Gonio Capsulotomy & Iridotomy Surgical 20D & 28D BIO Surgical Vitrectomy One Use. Perfect Optics. No Hassle. ULTIMATE PEACE OF MIND continued on page 162

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