Surgical technique for small-incision intraocular lens exchange

Karamaounas, Nikolaos; Kourkoutas, Dimitrios; Prekates, Christos

doi:10.1016/j.jcrs.2009.02.036

Cited by 15 publications

(8 citation statements)

References 12 publications

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“…In the technique of Mehta et al, 6 the IOL was incised radically extending beyond the optic center and removed by rotational movements through a 3.2-mm incision, which was described to be applicable for all incisions longer than 2.2 mm. Based on this technique, two radical cuts were performed following the method of Karamaounas 5 to make a triangular piece that was removed first, and the residual segment was rotated and explanted. Por et al 7 was the first to apply a 2-snip approach to trisect the IOL and subsequently explant the three pieces without rotation.…”

Section: Discussionmentioning

confidence: 99%

Modified Trisection Technique: One-Trip Explantation for Foldable Intraocular Lens

Zhang²,

Cao

et al. 2023

Retina

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Purpose: We present a new technique that allows an intraocular lens to be explanted through the small incisions used in modern cataract surgery.Methods and Results: The intraocular lens optic is cut into three connected pieces at the 1-mm-wide end with scissors. Then, with the stabilizing counterforce provided by a pair of vitreoretinal forceps through a paracentesis, the middle piece is removed first, followed by the two side pieces connected with haptics flipped over at the connected part. These two parts overlap each other when passing through the incision, eventually resulting in the explantation of the intraocular lens, as an intact piece.Conclusion: We believe this method provides a simple and effective way to remove intraocular lens through very small incisions, which could also reduce complications and hasten patient's recovery.

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Section: Discussionmentioning

confidence: 99%

Modified Trisection Technique: One-Trip Explantation for Foldable Intraocular Lens

Zhang²,

Cao

et al. 2023

Retina

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“…7,8 In patients with a preserved capsular bag, various techniques, including the bisection or trisection technique, 9,10 have been developed for extracting an IOL through a small corneal or scleral incision. In the absence of adequate capsule support, IOL extraction through a small surgical incision has 2 disadvantages: instability of the dislocated IOL and the risk for IOL segments to fall into the vitreous cavity.…”

Section: Discussionmentioning

confidence: 99%

Trisection technique for the extraction of dislocated intraocular lenses through a small surgical incision

Gekka¹,

Ogawa²,

Ohkuma³

et al. 2015

Journal of Cataract and Refractive Surgery

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“…3,[13][14][15][16][17][18][19][20][21][22][23][24] Scissors are available that allow lenses such as the Acrysof (SN60WF; Alcon, Fort Worth, TX) to be cut and removed through small corneal incisions, avoiding induction of astigmatism. 20 These lenses lend themselves to cutting, as they are relatively thin owing to their high refractive index (1.5542). For example, a 22-diopter (D) lens SN60wf measures 0.633 mm at its thickest.…”

Section: Introductionmentioning

confidence: 99%

Intraocular Lens Fragmentation Using Femtosecond Laser: An In Vitro Study

Bala¹,

Jun

Meades³

2015

Trans. Vis. Sci. Tech.

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Purpose: To transect intraocular lenses (IOLs) using a femtosecond laser in cadaveric human eyes. To determine the optimal in vitro settings, to detect and characterize gasses or particles generated during this process.Methods: A femtosecond laser was used to transect hydrophobic and hydrophilic acrylic lenses. The settings required to enable easy separation of the lens fragment were determined. The gasses and particles generated were analysed using gas chromatography mass spectrometer (GC-MS) and total organic carbon analyzer (TOC), respectively.Results: In vitro the IOL fragments easily separated at the lowest commercially available energy setting of 1 lJ, 8-lm spot, and 2-lm line separation. No particles were detected in the 0.5-to 900-lm range. No significant gasses or other organic breakdown by products were detected at this setting. At much higher energy levels 12 lJ (4 3 6 lm spot and line separation) significant pyrolytic products were detected, which could be harmful to the eye. In cadaveric explanted IOL capsule complex the laser pulses could be applied through the capsule to the IOL and successfully fragment the IOL.Conclusion: IOL transection is feasible with femtosecond lasers. Further in vivo animal studies are required to confirm safety.Translational Relevance: In clinical practice there are a number of large intraocular lenses that can be difficult to explant. This in-vitro study examines the possibility of transecting the lasers quickly using femtosecond lasers. If in-vivo studies are successful, then this innovation could help ophthalmic surgeons in IOL explantation.

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Surgical technique for small-incision intraocular lens exchange

Cited by 15 publications

References 12 publications

Modified Trisection Technique: One-Trip Explantation for Foldable Intraocular Lens

Modified Trisection Technique: One-Trip Explantation for Foldable Intraocular Lens

Trisection technique for the extraction of dislocated intraocular lenses through a small surgical incision

Intraocular Lens Fragmentation Using Femtosecond Laser: An In Vitro Study

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