EW CATARACT
33
February 2017
What was done
I decided to do an IOL exchange
here, and my decision was mostly
based on my concerns about having
a one-piece acrylic partially in the
sulcus. I thought that the pain and
tenderness in this eye was related to
the exposed haptic. I also thought
I could improve her refractive out-
come and give her a result similar to
the other eye. My goal was to place a
ReSTOR in the bag, and the backup
plan was a three-piece silicone IOL
in the sulcus correcting for distance.
Some have noted that a three-piece
would be to open the bag as much
as I could with a dispersive viscoelas-
tic and explant the existing lens. If
the bag opened sufficiently, I would
place another MFIOL inside the
capsular bag. If not, I would place a
three-piece MFIOL in the sulcus. I do
not think a toric is indicated as the
original surgeon had flipped her axis
with the T3.
"When everything quiets down
she will probably need a YAG. After
that is completed, I would reassess
her final manifest refraction and
her satisfaction. If there was trou-
blesome residual refractive error, I
would offer a surface ablation."
Figures 2 and 3. Patient's day 1 postoperative outcome. The ReSTOR IOL can be seen in the
capsular bag with the anterior capsule now lying completely over the IOL. The radial tear in
the anterior capsule did not extend, and the lens remained centered during follow-up.
Source (all): Steven Safran, MD
continued on page 34
