Going ahead with the Secondary IOL surgery?
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MS, DNB, FRCS (Glasg.) FAICO (Glaucoma)
Dr. Vijay Shetty has performed several Secondary IOLs implantations. He has used Sutured Scleral fixated lens, Glued IOL and Iris clip IOL.
About SECONDARY IOLs
What is a Secondary IOL?
Secondary IOL is a procedure in which after initial cataract surgery, an artificial lens(IOL) was not implanted in the eye. The indications for secondary intraocular lens insertion have evolved with improved surgical outcomes of modern cataract surgery. This results in poor vision and a large residual spectacle number.
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Dr. Vijay Shetty has compiled videos for you answering all of your Secondary Iol related queries.
About SECONDARY IOLs
When is the need for a Secondary IOL?
Inability to put the lens in the first sitting could be due to various reasons like absence of support due to broken posterior capsule or weak zonules.
1. Secondary IOL can be done for different reasons:
- Incorrect IOL power
- IOL luxation
- Opacification of IOL
- Photopsias
- Dissatisfied patient with multifocal IOL
- IOL induced inflammatory response and CMO.
- IOL induced endothlial decompdnsation.
- IOL removal and later 2ndary implantation in chronic endophthalmitis
2. After congenital cataract removal in children less than 1-2 years of age.
3. After complicated cataract surgery.
4. Trauma patients with crystalline lens loss.
5. Uveitis patients.
6. After refractive surprise.
The WHO/NPCB (National Programme for Control of Blindness) survey has shown that there is a backlog of over 22 million blind eyes (12 million blind people) in India, and 80.1% of these are blind due to cataract. The annual incidence of cataract blindness is about 3.8 million.
UNDERSTANDING SECONDARY IOL
Some important basics about Secondary IOL surgery
Secondary IOL is a procedure in which after initial cataract surgery, an artificial lens(IOL) was not implanted in the eye. This results in poor vision and a large residual spectacle number. Inability to put the lens in the first sitting could be due to various reasons like absence of support due to broken posterior capsule or weak zonules. Some of such situation demands to put a different kind of lens which takes support fromniris or a normal 3 piece foldable which is fixed to the sclera by sutures or glued IOL technique. This technique needs surgical expertise. Before the surgery the lens power required is calculated by measuring the eye parameters with various diagnostic tools and power is calculated using the formula. Type of the IOL is decided by the presence of intact iris tissue and presence of scleral disease. Iris clip is a simple and a quick procedure. Scleral fixated IOL needs a smaller incision whenever a foldable IOL is used.