Lens Replacement

Why do I need a Lens Replacement?

Lens Replacement is a procedure that   resolves multiple refractive conditions like presbyopia / hyperopia / myopia / astigmatism along with cataract as well.

However, a patient can undergo Lens replacement even if one does not have cataract, in which case it is termed as “Presbyopic Lens Replacement or PRELEX or even Clear Lens Extraction”..

Lens Replacement in cataract surgery: This is the best and only way to treat cataracts effectively. In order to restore vision the cataract affected natural lens would to be replaced with IOL (Intra Ocular lens). Intraocular lenses are artificial replacement lenses that are foldable, flexible and are implanted though the incisions made during the surgery after the removal of the natural lens.

Lens Implantation during a cataract surgery through phacoemulsification technique is performed without any stitches resulting in speedy healing and reducing the risk of complications. The procedure completes in few minutes.

Your life style and visual needs are considered while choosing the right lens. Accurate IOL calculations are essential for proper lens implantation. You would be advised on which type of lens is most suitable for you after assessment of your candidature for lens replacement is satisfactory.

Clear lens Extraction Surgery is useful for patients for whom LASIK treatment is not suitable [usually belong to an older age group]. Cataract surgery is a daycare procedure and lens implantation is performed one eye at a time. An interval is maintained between eyes to avoid infection. There are various types of IOLs according to the suitability and type e.g. monofocal, multifocal and toric lens.  

Monofocal IOLs: A type of traditional lens to resolve your distance vision although you may need glasses for near vision.

Lens replacement for correcting Presbyopia: Presbyopic IOLs like Multifocal IOLs (to focus distance as well as near) and accommodating IOLs (designed to move the eye muscles in order to adjust the right focus) are used during the cataract surgery to resolve Presbyopia. It eliminates or reduces the need of glasses for distance and near vision.

Lens replacement for correcting astigmatism:   Toric IOLs resolve astigmatism as well. Toric IOLs replace limbal relaxing incisions in the cornea to change its shape.

Lens Replacement Recovery: Lens Replacement recovery time is very quick and eye restores to normal vision rapidly although initially after surgery vision is slightly blurred.

  • Medication (eye drops) to safeguard infection [antibiotics] and inflammation [anti inflammatory] are instilled in the hospital as well as the person accompanying you would be explained and trained on its usage in order to continue the same at home.
  • You are advised to follow the instructions regarding the follow up visits after the surgery.
  • Eyes would be rechecked after the cataract surgery recovery for further correction in case required.

Shroff Eye Hospital facilitates your relatives to watch the live procedure telecast in the viewing area in the facility. Post surgery, you will be in a recovery area for a short time and then shifted to your allotted day bed. You are under observation in the post operative period, monitoring of the vital signs are also done. You would be discharged after post operative doctor’s check up and confirmation.

You would be sent home with a detailed list of instructions and medications. All post operative eye drops are provided by us for the immediate post operative period.

Our endeavour is to ensure you get the best possible treatment. Your eyes are important to us.

 

 

Lower your Cataract Surgery Risks Even Further

If a cataract surgery is advised, then delay or avoiding surgery is the biggest risk. Why? Because you could simply lose your vision and in certain cases such loss of vision is irreversible. As you know, surgery is the only logical solution to treat cataracts effectively; the real need is to take a decision at the right time. When you take a decision for surgery, half the battle is already won.

The phacoemulsification procedure for cataract removal is usually a satisfying surgical experience, using implants or (IOL’s) Intra Ocular lenses, which improves vision.

It is by far one of the safest and most common surgeries in modern times.

But how can one reduce surgery risks even further?

BEFORE CATARACT SURGERY

I] Choose the right hospital

  • One which is well equipped to handle any type of eye related issues, even if emergencies or complications arise.
  • One that utilizes latest technology and expertise.
  • A hospital that has excellent treatment plans to choose from and medical care in the best of facilities.

II] Choose the right surgeon

  • With good surgical expertise and experience. Learn as much as you can about him/her before you visit the clinic. You must strike a good rapport on your visit, such that you should be comfortable to ask any questions that concerns you, no matter how silly you think it may be.

III] Choose the right surgical procedure:

  • When you have made a wise selection of the hospital and surgeon, the right surgical procedure easily follows through. Your doctor will help you in narrowing down your treatment plans

Iv] Choose to undergo Routine Eye examinations:

  • It’s like having a regular maintenance contract for your eye. Helps to rule out abnormalities and treat eye diseases effectively at the right time or even prevent them before you see the signs and symptoms. The first eye examination begins at birth, then at regular intervals. When you undergo cataract surgery, it should continue even after surgery.

V] Choose to be in good overall health:

  • Not just eye care, a complete health care is vital. Exercise, nutritious diet, protection of eyes from trauma and UV rays by appropriate eye wear when outdoors for prolonged periods.

VI] Choose healthy lifestyle changes:

  • Incidence of High Blood Pressure and Diabetes could aggravate diseases like cataract and could further lead to complications. Smoking and alcohol increases risk of co morbidity. Hence due care should be taken at all times.

VII] Choose to know your vision needs:

  • Knowing what is going on with your body is very essential to help the treating ophthalmologists identify vision issues and advise the suitable solutions.

VIII] Choose to attend to any decrease in vision or other symptoms:

  • If you tend to ignore them, no other person or doctor can help you. You are the best person to first report them.

IX] Choose medication for other disorders when necessary:

  • Treat lower urinary tract symptoms, dental focus, as simple as they sound, it could turn out to be a focus of infection during your cataract surgery. Some medications need to be reported to the doctor, do not hide facts from them. For e.g. studies have indicated that Tamsulosin (Flomax) could cause IFIS (Intraoperative floppy iris syndrome).

AFTER CATARACT SURGERY

  • Safe guard against risk of infection and inflammation
    • Observation of instructions for medication as prescribed.
    • Timely consultation and follow up check up.
    • Follow guidelines on eye protection and eye care.
    • Taking precautions against infection like instilling eye drops in the right technique.
    • Avoid rubbing the eye.
    • After surgery biannual consultations or annual consultations will help you.
    • Keep free from dust, allergens and unhygienic conditions.
  • It is advisable to opt for cataract surgery in the second eye after the first eye recovers at a specific gap to avoid infection. This usually is about 7 days or more.
  • Trust your doctor and the team: This increases your self confidence for the surgery and helps you to deal with your vision issues in a better way.

Assuring you of our best support and treatment.

Possible Short-Term Side Effects from Cataract Surgery

Cataract surgery is considered to be the safest and most commonly performed surgery worldwide and has a very high success rate. Just like every surgery there also lies an inevitable undesired element of side effects. Most people have faced no side effects. However, one should be alert regarding the same, because if treatment is ignored it may turn serious. Normally the side effects are short term and easily treatable.

The knowledge of the possible short term side effects, should they arise, helps in better understanding and preparation to combat the same. Let us understand some of the common possible issues due to cataract surgery that goes beyond what is desired.

  • Side effects from Medication: These relate to any side effects observed before, during or after surgery due to administration of medicine/eye drops even anesthesia for cataract surgery. These need to be immediately reported. You would be advised accordingly in case medicine needs to be reduced in dosage or discontinued completely.

Some of the ancillary effects: Small incision cataract surgery (Phacoemulsification) itself has reduced the risk to side effects. However in rare case the conditions listed below could occur in some cases.

  • Inflammation: Ie.g Uveitis in rare cases. This is associated with redness, tearing and light sensitivity. Sometimes, eye lids swell up and there is mild to moderate pain. This usually occurs when the post surgery eye drops are suddenly stopped and if there is any underlying cause for inflammation, such as a dental or gum infection. Oral anti inflammatory eye drops for inflammation is prescribed.
  • Bleeding: With small incision surgery there is almost no bleeding during surgery. Moreover cornea does not have blood vessels.   However, in rare cases bleeding may occur in back of the eye (vitreous).
  • Mild pain and discomfort: Usually just after surgery a mild discomfort is common which gradually reduces or responds to any simple pain killers.
  • Sensitivity to bright light: The temporary side effect of light sensitivity is common for few days, which is why dark protective glasses or good sun wear is advised when outdoors.
  • Redness: Mild redness in some cases which is expected to reduce within a day or two.
  • Eye Pressure variations: Variation in the intraocular pressure could arise in some cases.

 

Other side effects after cataract surgery that affect the eye:

  • These could result due to the presence of other health conditions like diabetes and hypertension.
  • Caused due to other eye diseases like age-related macular degeneration or glaucoma.
  • Caused due to medications from previous eye surgeries.

Measure to minimize the side effects: Shroff Eye Hospital ensures that cataract surgery is performed with minimal side effects.

  • Understanding of overall health condition while treating cataracts.
  • Regular check up and consultation is an opportunity to share the information about the medications taken and understanding of other prevailing health conditions.
  • Use of latest technology and expertise.
  • Constant monitoring of eye pressure, body pressure and sugar levels at various intervals and follow ups.
  • Surgery is performed only if you are fit for the surgery and right candidate for the same.
  • Patients are taught and trained on eye care methods right from instilling eye drops before surgery to various processes till the complete healing of the eye.
  • Zero Infection goal: Surgeries are performed with highest rate of sanitization to avoid any infection of any kind. Oral antibiotics and eye drops to prevent infection is prescribed in various stages. Proper eye care and effective use of eye drops after surgery prevents infection.
  • Due precautions are taken to maximize success rate and minimize side effects from cataract surgery.

Rare Complications from Cataract Surgery

Let’s preview and understand the rare complications from cataract surgery.

Complications are classified as below:

  • Pre operative like local anesthesia side effect or allergic conjunctivitis.
  • Intra operative like posterior capsular tear.
  • Post operative conditions.

Post operative rare complications could occur either immediately after cataract surgery or after a long gap may be months or years after surgery.

Post operative complication indicators:

  • Floaters
  • Elevated eye pressure
  • Redness
  • Pain
  • Swelling
  • Loss of vision
  • Bleeding
  • Eye watering

Early post operative rare complications:

  • Hyphema
  • Iris Prolapse
  • Flat anterior chamber
  • Post Operative Anterior Uveitis
  • Toxic Anterior Segment Syndrome

Late Post operative complications:

  • PCO (Posterior Capsule Opacity): This is commonly known as secondary cataract occurring within months or years after cataract surgery. After cataract surgery normally after a day the vision improves but in case you notice that you eyes are still hazy and vision is not clear. This could be an indication for PCO due to the thickening of the lens capsule. In such cases do consult and have your eyes checked in order to confirm the issue and get effective treatment. YAG laser capsulotomy is a painless procedure to resolve the same within minutes.

Rare complications include:

  • Retinal detachment: The patient experiences floaters, curtain like loss of vision. Floaters could occur due to posterior vitreous detachment.
  • Dislocated Intraocular lenses: Intraocular lens are placed inside the capsular bag which could rapture or break. It could happen due various reasons like zonular dialysis. Intraocular lenses need to be repositioned back to have clear vision. In such cases you may notice double vision.
  • Cystoid Macular edema: This is caused mainly due to accumulation of fluid in the macula. Anti inflammatory eye drops are prescribed to reduce the swelling of the retina.
  • Endophthalmitis: It is an infection and it presents generally as red eye, pain and loss of vision.

Precautions and points to note:

  • It is advisable to consult early if any symptoms or vision difficulties crop up, so that healing would be faster and treatment would be more effective. In case of delay it could lead to further complications and could also result in loss of vision.
  • An annual checkup is advisable even if there are no symptoms of complication.
  • A proper pre evaluation before surgery and good after surgical care prevents complications.
  • Those patients who already have other eye diseases along with cataract are more prone to the risk of complications after surgery e.g. diabetic retinopathy. Post operative eye trauma can also cause complication. Hence due attention needs to be given.
  • Medication and corrective surgery corrections help to treat complications. E.g. Vitectomy is done in case complications arise due to retained lens material.

Why are complications with phacoemulsification very rare?

  • Modern cataract surgery involves small incision, no stitches- so less infection and faster healing.
  • Use of advanced technology.
  • Use of latest surgical methods.

Modern cataract surgeries are performed by phacoemulsification under local anesthesia (eye drops). This reduces risk and complications and is generally highly successful.

 

History of Cataract Surgery

The evolution of cataract surgery has brought changes in various aspects in terms of treatment and surgical procedures. This has created faster recoveries and better experience of enhanced vision.

Cataract Surgery in Antiquity:                        

  • 6th century BC- The Sanskrit manuscripts had the earliest evidence about an Indian surgeon Sushruta. He used the couching technique where the lens had become completely opaque and supporting zonules got fragile, the lens was stuck with a blunt object forcing the lens to dislocate into the vitreous cavity. This was later modified into a sharp fine instrument. This is the first recorded form of cataract surgery. Absence of any corrective lenses had resulted in unclear vision even after the surgery.
  • 29 AD– Needling Technique was performed wherein absorption of the cataract after breaking it into multiple pieces. The patient’s cornea was pricked with a needle to remove the cataract. No anesthesia was used and it had resulted in infections.

           Cataract surgery in the Modern Era:

  • 8th April 1747– The first cataract extraction from normal position behind the iris was conducted by Jacques Daviel.
  • 1798(Paris) – During the Modern Era the first surgical removal of cataract was initiated. In the early days cataract surgery was mainly performed in advanced stage when the opaque lens was completely mature so that the lens could be taken out from the cornea in one piece to avoid any fragmentation. Initially sutures did not exist at time and patient was kept immobilized using sandbags around their head. After five years, the first whole lens removal was done.
  • 1884: First cataract surgery under anesthesia with cocaine was performed.

Cataract Surgery in 20th and 21st Century Era: The lens extraction was the standard    procedure during this period. Twentieth century marked the introduction of ophthalmic sutures and new anesthesia techniques.

  • 29th Nov 1949 (England) – Evolution of intraocular lenses- A major milestone was when Howard Ridley performed the first intraocular lens surgery. His pioneer work created the first artificial lens. Development further progressed on lens that restore good visual outcome for near and distance vision.
  • 1967– Phacoemulsification was first performed by Dr. Charles Kelman. He was a pioneer in this technique. The idea was conceived when he had been to the dental surgeon who used ultrasound for his dental plaque removal. Dr. Kelman used an ultrasonic probe in order to break the lens into fragments .This was further aspirated using the same probe through a small incision (3mm to 1 mm size). Initially after a cataract surgery, “Coke bottle” – thick hyperopic glasses were used which gradually reduced after the introduction of intraocular lenses.
  • 1980- Danielle Aron-Rosa introduced the (Nd-YAG) laser for performing posterior capsulotomy. The complications in Intracapsular cataract extraction lead to the extracapsular cataract extraction in the 80’s.

Today modern cataract surgery is the product of persistent research and innovation throughout ages. We are in an era with better surgical outcome complemented with the latest innovations in design and material used in lens and techniques in cataract surgery.

 

Treating PCO (Posterior Capsular Opacification)

Posterior Capsular Opacification (PCO): The opacity of the posterior capsule which holds the intraocular lens is called Posterior Capsule Opacification.

Types of PCO :

  • Fibrosis type.
  • Pearl type.
  • Combination of both.

Treatment of Posterior Capsular Opacification: The symptoms that occur are quite similar to that of cataract like blurring vision, halos and glare etc. PCO is often misunderstood by many and it seems like cataract has resurfaced. It is also called ‘secondary cataract’ or ‘after cataract’. During a cataract surgery, the natural lens is removed from the anterior position of the lens capsule. It is replaced by a new lens (IOL) letting the eye regain vision. The posterior position of lens capsule is left intact in order to support the IOL.

In rare cases, the posterior capsule lining gets hazy causing vision disturbances due to various factors eg. the regrowth of the residual lens epithelial cells. Nd:YAG posterior capsulotomy is considered to be very effective for PCO treatment. Other alternative treatments are direct injection into the anterior chamber or impregnation of the IOL.    

In case of primarily fibrosed capsules the treatment may vary as clear fibrosis facilitates this treatment. Innovation in the material used in the lens, IOL shapes, IOL designs and therapeutic agents etc. have been researched extensively to prevent PCO formation or delay early onset.

What happens during the Nd: YAG posterior capsulotomy? The alternatives, risks, benefits of the treatment are discussed before the treatment.

  • Dilation of the pupil of affected eye with eye drops.
  • YAG Laser creates a minute hole in the posterior capsule of the eye from the line of sight in order to let the light to pass through the eye from the retina to get clear vision.
  • Anti – inflammation drops are instilled to combat post operative inflammation.

A slit lamp is used during the procedure. It is an outpatient procedure and anesthesia is not used generally. Sedation/tropical drops is given in certain case for children or non co-operative patients as it is essential to remain still during the procedure. Generally normal vision is expected after a day and entire procedure last for few minutes. The recovery time could vary from person to person.

Advantages of the treatment:                                                             

  • Glare is reduced.
  • Vision acuity gets improved.
  • Double vision is cleared.
  • YAG Laser is used in the treatment.
  • Absence of incisions reduces infections.
  • Safety and effectiveness of the procedure in regaining vision.
  • Low complication rate.

PCO Risk: Most common risk is the increased IOP (Intraocular pressure) for short duration. Some experience temporary floaters which is quite normal and in rare cases retinal detachment could also occur. In case conditions like muscular degeneration is already present may affect the visual outcome after the procedure.

With advanced surgical techniques and choice of right IOL selection PCO has significantly deduced nevertheless, after a recent cataract surgery if you are facing vision issues, do get in touch with us for further details.

Cataract Surgery For Children

Cataracts occur in children at birth or after. Unlike adults, cataracts in children are likely to get unnoticed, more difficult to determine and are not as common. Exact cause is still unknown. A newborn’s eye test should not be avoided, particularly if the child is premature and if there is a history of congenital cataract in the family. Cataract surgery in case of pediatric cataracts is most effective in the first month after the birth. In elder children any difficulties in reading, writing that impairs vision and should not be ignored.

Risk factors for Pediatric cataracts.

  • Congenital cataract: Cataract or lens opacity at birth in children. These could be due to hereditary/genetic, metabolicg. galactosaemia or in-utero infection related conditions.
  • Developmental cataracts: They are due to genetic or metabolic e.g. galactokinase deficiency conditions.
  • Acquired cataracts: They are due to metabolicg. diabetes mellitus, traumatic or post radiotherapy conditions.

Most common symptoms of cataracts in children:

  • Unable to see clearly / blurring
  • Visible white spot in pupil.
  • Improper eye alignment.
  • Unusual rapid eye movements.
  • No reaction to colorful stimuli or larger objects.

How eye condition in cataract surgery in children is different from adults

  • Potential for amblyopia
  • Unlike adults longer life span after cataract removal
  • Change in axial length and corneal curvature with time
  • Increased tissue reactivity and decreased scleral rigidity
  • Smaller size (compared to the adult eye)
  • Lenses are softer.
  • Capsule is comparatively more elastic

 Surgical Treatment: Cataract surgery in children is a daycare procedure. The approach changes according to the age, nature of the eye, type of cataract, onset and diagnosis etc. Sometimes surgeries are conducted under anesthetic drops or in some cases children are anesthetized with general anesthesia. In kids, eyeball growth is rapid and higher risk for possible rejection so initially contact lens are used and when the child is suitable by age and prevailing conditions are conducive only then contact lenses are replaced by IOLs.

Precautions for pediatric cataract surgery:

  • After surgery
    • Ensure that medication, follow up is adhered to.
    • Ensure that the child takes good rest.
    • Bending to pick objects is restricted.
    • Due protection and care is taken for the operated eye as instructed like avoid rubbing, strain, etc.

Complications: Normally complications are more in children compared to adults. Few common ones are:

  • Amblyopia
  • Posterior capsular opacification
  • Glaucoma
  • Retinal detachment

Post operative follow up: Regular post operative test and follow ups are important for the overall visual outcome. We closely monitor your child for the visual development to detect any post operative complications. Further as the eye matures the glasses or contact lens need to be changed and the eye ware consultation details would be informed.

At Shroff Eye Care, your child would experience unmatchable highly refined surgical techniques with the vast expertise of surgeons handling pediatric surgeries of children from all age’s right from birth.

Do get in touch with us for appointment and more details.

The Cataract Incision

The Cataract Incision may seem to be a small word in the gamut of ophthalmic terminologies; nevertheless it has a major impact on the wound construction and visual acuity outcome.

After the eye is prepared for surgery, an incision (cut) is carefully made on the edge of the clear cornea. According to the type of surgery conducted the size of the incision varies. Today smaller incisions are possible without any stitches thereby enabling you to quick recovery, fast healing and less likely to get infected.

What are the major considerations in a cataract incision?

  • Location- One of the major factors affecting the degree of astigmatism is the distance of the incision from the center of the cornea, the size of the incision and its shape.
  • Size- Size refers to the area of the wound in terms of its length and width. Smaller the incision lesser the astigmatic effect.
  • Shape- Incisions are made in different shapes according to the favorable factors   e.g. curved, straight, frown, keyhole or chevron.
  • Architecture– Architecture is denoted by the number of incision planes. If the incision construction is not perfect it could lead to endophthalmitis. OCT (Optical coherence tomography) is an instrument used to examine the incision construction and architecture. Incisions in multiple planes ease self sealing thereby reducing the risk of infection.

Incision configuration and manipulation.

Corneal relaxing incisions (Limbal relaxing incisions): These are tiny incisions made on the cornea at precise location to reduce astigmatism.

Features for an ideal incision irrespective of the type of surgery.

  • Postoperative astigmatism – An ideal incision aims in achieving astigmatic ally neutral results.
  • Well balanced – The size and form of the incision gives the fluidic balance during the surgery.
  • Watertight – Watertight incisions avoid leakages and infections and aids faster healing.
  • Stability- The incision should be stable without causing any openings.

Surgeries versus incision size:

  • Standard extracapsular surgery incision size – usually 10-12 mm. has higher risk of infection and takes more healing time.
  • Manual small incision surgery incision size –Usually 5.5 mm to 7.0 mm. clear corneal incisions is one of techniques implemented.
  • Instrumental phacoemulsification incision size– Usually around 2.2 mm. Phase needle and probe is used for the incision.
  • Micro cataract surgery incision size– Usually 1.8mm
  • Femtosecond assisted Laser cataract surgery incision size– Usually 1 mm. In this surgery the flap is made by the laser and multiplanar incisions are repeatable.

The control over Fluidic balance, infection resistance and astigmatism are of paramount importance in any cataract incisions done.

The type of surgery opted and procedure details would be made clear to you prior to your cataract surgery. After a cataract surgery you would be advised to avoid rubbing, forceful blinking or any kind of pressure on the eyes to avoid any damage to the newly made incisions.

With advances in intraocular lens implant and progressive changes in the cataract incisions, you can now experience a painless surgery and obtain faster recovery after a cataract surgery.

Dislocated Intraocular Lenses

During a cataract surgery an intra ocular [artificial lens] is placed in the capsule of the natural lens of the eye, after the cataract affected lens is removed. The capsule supports or holds the artificial lens and prevents dislocation. However, sometimes the lens gets dislocated from its original position to another position. This is known as dislocation of the IOL [intra ocular lens].

This is one of the major, but uncommon intra operative or post operative complication after a cataract surgery or an Nd YAG posterior capsulotomy. Dislocation of the intraocular lenses may occur due to trauma during surgery or with systemic diseases where the capsular support weakens.

IOL dislocations are categorised as ‘in-the- bag’ and ‘out- of- the- bag’. The most common in-the-bag etiologies are pseudoexfoliation [deposition of whitish-grey protein material on the lens surface] and prior vitreoretinal surgery. IOL dislocation could either be early if it’s within three months of cataract surgery or late if it’s beyond three months of cataract surgery. Dislocation of IOL has estimated occurrence in 0.2% to 3% of cases.

Signs and Symptoms

This depends on the degree of malfunction. The patient may notice the edge of the lens implant or even have double vision. If the lens implant dislocates entirely out of the visual axis, the patient may have a very substantial drop in visual acuity, usually to the “counting fingers” level.

Dislocated intraocular lenses

 

Degree of malfunction:

  • Mild (where the optic covers more than half of the pupillary space)
  • Moderate (where the optic covers less than half of the pupillary space)
  • Subluxated
  • Luxated (completely dislocated)

Symptoms:

  • Streaks of light.
  • Sudden blurry vision.
  • Decrease in vision.
  • Edge glare.
  • Diplopic (double vision).
  • Induced astigmatism.

Causes:

  • Pseudo exfoliation
  • Prior vitreoretinal surgery
  • Trauma – Rubbing the eyes hard after cataract surgery can cause dislocation
  • Increased Axial length
  • Associated with syndromes such as Marfan’s syndrome

Diagnosis:  A dilated slit-lamp examination is conducted along with other tests. One of the challenges which surgeons face is the movement of the bag – IOL as the location may changes according to your resting or sitting position during the examination.

Treatment: Usually treatment is surgical.

Dislocated IOL is treated by moving the lens into the correct position, or replacing the lens. In most cases the gel in the back of the eye, or vitreous, must be removed in part through the surgical process called “vitrectomy”. Once the lens is free of the vitreous gel it can be moved more safely and repositioned or replaced. In some cases a new lens can also be sewn into the back of the eye.

Hence, the treatment differs on a case to case basis.

Vitrectomy: This surgical procedure is conducted to remove the vitreous gel from the central cavity of the eye. The various approaches are Anterior vitrectomy (anterior approach to fixate the implant when the lens is   subluxated but still stable within the anterior segment). In some cases the IOL is unstable or dislocated posterior into the vitreous cavity then IOL is retrieved through the posterior segment or a Pars plana Vitrectomy.

  • IOL Removal – IOL is removed based on certain factors like damaged  haptics, small optics, highly flexible haptics which does not support sutures, eyes with a poor visual prognosis, associated complicated retinal pathology such as retinal detachment, or damaged IOLs.
  • IOL Repositioning – IOL is surgically rotated and repositioned and fixed in the right place..
  • IOL exchange – Wrong IOL power and malposition is the main indication for the IOL exchange.

Depending on your type of IOL and specific anatomic considerations, you would be suggested on the type of treatment most suitable. The existing symptoms, visual needs, and expectations are considered before finalizing the treatment. We endeavour to give you the best treatment with minimal risk and long term visual outcome.