Secondary diffractive bifocal piggyback intraocular lens implantation

Alfonso, José F.; Fernández-Vega, Luís; Baamonde, M. Begoña

doi:10.1016/j.jcrs.2006.06.028

Cited by 26 publications

(21 citation statements)

References 24 publications

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“…Given that New hydrophilic acrylic supplementary IOL N Reiter et al patients' expectation are quite high for spectacle free vision, this type of secondary intervention offers a valuable alternative for optical enhancement after cataract surgery; whether it be to correct a refractive surprise or to add a premium function such as multifocality or toricity to the primary IOL. [12][13][14][15][16] The study lenses included premium characteristics like diffractive optic (A45D) or extra addition for macular diseases (A45SML), whereas toric features are also commercially available on the same IOL platform. However, the optical properties were not relevant in our study.…”

Section: Discussionmentioning

confidence: 99%

Assessment of a new hydrophilic acrylic supplementary IOL for sulcus fixation in pseudophakic cadaver eyes

Reiter

Werner

Guan

et al. 2017

Eye

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Purpose Management of refractive errors after cataract surgery includes spectacles or contact lens, secondary laser vision correction, intraocular lens (IOL) exchange, or piggyback lens implantation. We evaluated for the first time a single-piece hydrophilic acrylic IOL designed for supplementary sulcus fixation in postmortem pseudophakic human eyes. Methods Pseudophakic human cadaver eyes were imaged by anterior segment optical coherence tomography (AS-OCT) to assess position of the primary IOL. Eyes were prepared as per the Miyake-Apple technique. The supplementary IOL (Medicontur A4 Addon IOL family) was then inserted into the ciliary sulcus. AS-OCT and photographs from anterior and posterior views were used to assess IOL centration, tilt, and interlenticular distance from the primary IOL. Results Data were obtained from 12 eyes having primary IOLs of varying materials and designs in the bag and representing different sizes of eyes and severity of Soemmering's ring formation. The A4 Addon IOL was successfully inserted into the ciliary sulcus and was well centered in all cases. Four cases of tilt were observed on AS-OCT: three with mild tilt due to pre-existing zonular dehiscence, and one due to a localized area of Soemmering's ring formation. Interlenticular distance ranged from 0.34 to 1.24 mm and was not dependent on severity of Soemmering's ring or type of primary IOL. Conclusions The A4 Addon IOL was designed for sulcus fixation as a supplementary lens, with a large diameter, a square-shaped optic, four smooth loop haptics, and a convex-concave optical surface. It exhibited appropriate centration and interlenticular distance with different primary in-the-bag IOLs.

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Section: Discussionmentioning

confidence: 99%

Assessment of a new hydrophilic acrylic supplementary IOL for sulcus fixation in pseudophakic cadaver eyes

Reiter

Werner

Guan

et al. 2017

Eye

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“…The technique was then extended to correct pseudophakic spherical 2 or astigmatic 3,4 refractive errors. Because of the position of both IOLs in the capsular bag, complications such as interlenticular opacification [5][6][7] and changes in refractive results due to shift of the second IOL 8,9 were observed. Thus, the authors recommended implanting the second IOL in the ciliary sulcus.…”

Section: J Cataract Refract Surg 2012; 38:986-991 Q 2012 Ascrs and Escrsmentioning

confidence: 99%

“…In the past, even multifocal IOLs were implanted in the sulcus to provide uncorrected near visual acuity. 8,9 However, these IOLs were not designed to be placed in the sulcus, and iris capture of the second IOL 10 or pupillary block with consequent glaucoma 11 have been reported.…”

Section: J Cataract Refract Surg 2012; 38:986-991 Q 2012 Ascrs and Escrsmentioning

confidence: 99%

Sulcus anatomy and diameter in pseudophakic eyes and correlation with biometric data: Evaluation with a 50 MHz ultrasound biomicroscope

Petermeier¹,

Suesskind²,

Altpeter³

et al. 2012

Journal of Cataract and Refractive Surgery

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DESIGN: Case series. METHODS:In pseudophakic eyes, the axial length (AL) and horizontal WTW were measured by the IOLMaster device. Cross-sectional images were obtained with a 50 MHz ultrasound biomicroscope on the 4 meridians: vertical, horizontal (180 degrees), temporal oblique, and nasal oblique. Sulcusto-sulcus (STS), angle-to-angle (ATA), and sclera-to-sclera (ScTSc) diameters were measured. The IOL optic diameter (6.0 mm) served as a control. To test reliability, optic measurements were repeated 5 times in a subset of eyes. RESULTS:The vertical ATA and STS diameters were statistically significantly larger than the horizontal diameter (PZ.0328 and PZ.0216, respectively). There was no statistically significant difference in ScTSc diameters. A weak correlation was found between WTW and horizontal ATA (r Z 0.5766, P<.0001) and between WTW and horizontal STS (r Z 0.5040, PZ.0002). No correlation was found between WTW and horizontal ScTSc (r Z 0.2217, PZ.1217). CONCLUSIONS:The sulcus anatomy had a vertical oval shape with the vertical meridian being the largest, but it also had variation in the direction of the largest meridian. The WTW measurements showed a weak correlation with STS. In pseudophakic eyes, Soemmerring ring or a bulky haptic may affect the ciliary sulcus anatomy.

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“…Recently Jin et al [14] reported effective correction of residual astigmatism with placement of a toric IOL in the sulcus using an obliquely crossed cylinder technique. Alfonso et al [15] have described placing diffractive multifocal IOLs in the sulcus to provide pseudoaccommodation, and Boisvert et al [16] have developed a pediatric piggyback IOL calculator to facilitate the strategy of temporary polypseudophakia in young children by removing the anterior IOL when the eye becomes sufficiently myopic due to the expected physiologic shift in refraction.…”

Section: Piggyback Iolsmentioning

confidence: 99%

Enhancements After Premium IOL Cataract Surgery: Tips, Tricks, and Outcomes

Packer

2013

Curr Ophthalmol Rep

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Surgeons utilize enhancement procedures following premium IOL cataract surgery to reduce or eliminate residual refractive error and improve spectacle independence for their patients. The decision to perform an enhancement and the timing of enhancement surgery are often highly individualized and depend on the expectations and specific goals of the patient. Surgeons can maximize outcomes by understanding the multiple factors impacting patient satisfaction, maintaining a commitment to effective counseling, performing meticulous pre-operative diagnostic testing, adhering to the highest standards of surgical practice and honestly evaluating their surgical results.

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Secondary diffractive bifocal piggyback intraocular lens implantation

Cited by 26 publications

References 24 publications

Assessment of a new hydrophilic acrylic supplementary IOL for sulcus fixation in pseudophakic cadaver eyes

Assessment of a new hydrophilic acrylic supplementary IOL for sulcus fixation in pseudophakic cadaver eyes

Sulcus anatomy and diameter in pseudophakic eyes and correlation with biometric data: Evaluation with a 50 MHz ultrasound biomicroscope

Enhancements After Premium IOL Cataract Surgery: Tips, Tricks, and Outcomes

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