EW CATARACT
31
April 2018
Figure 3. Opacified Akreos IOL
Figure 4. 1 week postop
were to dislocate later, one could
suture the CTR, or if things be-
came similar to the left eye, I could
remove the bag and use the Yamane
technique for scleral fixation with
this IOL. Intraoperatively, I would
use Shugarcaine to augment pupil
dilation. I would also have two CTS
available in case there was large
zonular dialysis that would require
additional capsular support. De-
pending on her IOP/HVF, I would
also do a MIGS procedure, such as
an iStent [Glaukos, San Clemente,
California] at the time of surgery.
"After allowing for the right eye
to heal, I would discuss surgical op-
tions for her left eye. If she wished
to proceed with surgery, I would
remove the Akreos/bag complex
and perform a thorough vitrectomy,
then use the Yamane technique to
scleral fixate an EC-3 PAL in this
eye. Also depending on her IOP/
HVF in this eye, I would consider a
MIGS procedure such as a Kahook
Dual Blade [New World Medical,
Rancho Cucamonga, California].
What was done
I offered this patient the choice of
which eye to tackle first, and she
wanted to fix the dislocated lens in
the left eye. My original plan was to
lasso this Akreos lens/bag complex
with Gore-Tex sutures using the
continued on page 32
Figures 5 and 6. Melted haptic tips seen at the slit lamp (tip of arrows)
Source (all): Steven Safran, MD
Video 2. IOL
exchange/PPV/
double needle
ISHF/KDB blade
Video 1. Gore-Tex
suture lasso of
dislocated Akreos
IOL/bag complex
