PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Eric C. Amesbury MD Kevin M. Miller MD The authors have no financial interest.

Slides:

Advertisements

Similar presentations

Fernando Llovet, MD, PhD. Contributing Authors: Margarita Cabanás, MD; Jaime Beltrán, MD; Julio Ortega-Usobiaga, MD; Clara Martín- Reyes, MD; Victoria.

Advertisements

Keiichiro Minami, Hiroko Bissen-Miyajima, Mami Yoshino, Kunihiko Nakamura Department of Ophthalmology Tokyo Dental College Suidobashi Hospital, Tokyo,

V. S. Liarakos, K. van Dijk, L. Ham, L. Baydoun and G.R.J. Melles Anterior Chamber vs Posterior Chamber IOL in DMEK for Pseudophakic Bullous Keratopathy.

In-the-Bag Toric IOL for Correction of Astigmatism in Keratoconus and after Corneal Surgery Bart T.H. van Dooren, M.D., Ph.D Ilse E.M.A. Mol, M.D. Department.

Sulcus-Placed Single-Piece Acrylic IOL After Posterior Capsule Tear A.K. Junk, S. R. Wellik Bascom Palmer Eye Institute, Miller School of Medicine, University.

Visual outcome & subjective visual symptoms of the Tecnis ZM900 multifocal intraocular lens in Asian eyes Dr Colin S.H. Tan MBBS, MMed (Ophth), FRCSEd.

Forms of Cataract 1) Developmental (in general non progressive)

Astigmatism Following 2 IOL Injection Techniques: Wound Assisted Versus Wound Directed Jay J. Meyer, MD Hart B. Moss, MD Kenneth L. Cohen, MD University.

Anupama Kotha 1, Simar J. Singh 1, William B. Trattler 1,2, Carlos Buznego 1,2 The authors have no financial interest in the subject matter of this poster.

A Prospective, Randomized, Comparative Evaluation of Patients with Contralateral Implantation of Two Aspheric Acrylic Intraocular Lenses R. Cionni, MD.

Eltutar, Kadir; Akcetin, Tulay A.; Ozcelik, N. Demet Istanbul Education and Research Hospital Department of Ophthalmology The authors state that they have.

Ruth Lapid-Gortzak MD PhD 1,2, Jan Willem van der Linden BOpt 2, and Ivanka J. van der Meulen MD 1,2 1 Department of Ophthalmology, Academic Medical Center,

Phakic cadaver eye (horizontal meridian). Pseudophakic cadaver eye (horizontal meridian)

Phacoemulsification with Goniosynechialysis in the Management of Refractory Acute Angle-closure Glaucoma Ghasem Fakhraie*, MD, Mahmoud Jabbarvand, MD,

M. Allison Roensch, MD, Preston H. Blomquist, MD, Nalini K Aggarwal, MD, James P. McCulley, MD Department of Ophthalmology University of Texas Southwestern.

Justin Charton, MD, Preston H. Blomquist, MD, Nalini K. Aggarwal, MD, James P. McCulley, MD University of Texas Southwestern Department of Ophthalmology.

Second generation: Collamer™ (?) Fyodorov lens. Third generation: Staar ICL -Material: Hydrophilic collagen polymer (63% hydroxy- ethyl-methyl-acrylate;

Implantation of a single-piece acrylic intraocular lens using an anterior chamber maintainer Tomoyuki Kunishige, Hisaharu Suzuki, Toshihiko Shiwa, Hiroshi.

The Effect of the Restor Multifocal IOL on Frequency Doubling Perimetry Elizabeth Yeu, MD1, Elizabeth Woznak, BS2, Nicole Kesten, BS2, Steven VL Brown,

©DZ Reinstein 2009 One and two-year clinical outcomes of LASIK for high hyperopia Dan Z Reinstein MD MA(Cantab) FRCSC 1,2,3,4.

The authors have no financial interest in the subject matter of this e-poster M. K. Kummelil, S. Nagappa, A. Shetty Cataract and Refractive Surgery Services,

PIGGYBACK IMPLANTATION OF FOR HIGH HYPEROPIA 24 MONTHS FOLLOW UP JL. FEBBRARO I.VIELPEAU, F. KRIFA, S.BERBACHE, S. GANEM Department of Ophthalmology S.

The Second Report of The National cataract Surgery Registry PATIENTS’ CHARACTERISTICS Table 1.1: Age Distributions.

Blended vision after bilateral monofocal cataract surgery: an evaluation of spectacle independence and vision related quality of life Allison Landes, MD.

Femto-Lasik after corneal transplantation

Phacoemulsification in eyes with previous anterior chamber phakic IOL surgery Walton Nosé, MD, PhD 1,2 Adriana dos Santos Forseto, MD 1 Mariana Ávila,

Unilateral multifocal lens implantation in patients with a contralateral monofocal or phakic eye is a viable presbyopic correction option Robert J. Cionni,

Neeti Parikh, MD Fuxiang Zhang, MD Department of Ophthalmology Henry Ford Hospital A Comparison Of Patient Satisfaction With Modified Monovision Versus.

Biometric Accuracy in High Hypermetropes and Myopes

Glaucoma and Penetrating Keratoplasty : Incidence, Risk Factors, and Outcomes Sonika Gupta Consultant Ophthalmology Max Eye Care New Delhi, India Author.

Phakic posterior chamber IOLs 1.Cells involved in crystalline lens and capsular bag opacification 2.Evolution of designs of PPCIOLs 3.Relevant aspects.

AlphaCor TM : A Novel Approach to Minimize Late Post-operative Complications V. Ngakeng MD, M. Price PhD. MBA, F. Price MD.

LADARVision4000 Vs VISX CustomVue LADARVision4000 Vs VISX CustomVue CustomCornea CustomCornea A Comparison of Wavefront Guided Refractive Surgery outcomes.

Ruth Lapid-Gortzak MD, Jan Willem van der Linden, BOpt,

Kaori Morii, M.D. Shinji Miura, M.D, Ph.D. Dept. of Ophthalmology, Asagiri Hospital, Hyogo, JPN We have no financial interest. This retrospective study.

Effect of Ocular Deviation on Pupil size with Implanted Multifocal Intraocular Lens Yoshihiko Iida, MDKimiya Shimizu, MD Misae Ito, CO Kitasato University.

The authors have no financial interest in the subject matter of this poster. FINANCIAL DISCLOSURES.

Comparison of LASIK and Mitomycin-C Assisted LASEK for Correction of Refractive Errors After Cataract Surgery Dr. Nitin Balakrishnan, Crystal Vision Laser.

Combined cataract surgery and endoscopic cyclophotocoagulation in patients with glaucoma without prior incisional glaucoma surgery Matthew P. Traynor,

Multifocal Intraocular Lenses Abdullah Al-assiri Mansour Farooqui Abdulrahman Al-Muammar Saudi Ophthalmology Meeting 2009.

Faik Orucov*, MD, Sinan Goker*,MD, Abraham Solomon**, MD, Joseph Frucht-Pery**, MD *Refractive Surgery Department, ISTANBUL SURGERY HOSPITAL Istanbul,

Controversies about binocular function and patient satisfaction after induced conventional monovision in case of bilateral intraocular lens implantation.

Visual and IOP Outcomes after PRK in Pigment Dispersion Syndrome [Poster Number: P190] Kraig S. Bower, Denise A. Sediq, Charles D. Coe, Keith Wroblewski,

Uveitis-Glaucoma-Hyphema Syndrome Constanze Kortuem, Daniela Suesskind, Manfred Zierhut Centre for Ophthalmology University of Tuebingen, Germany.

Comparison of visual function following piggyback implantation of Acrysof ReSTOR intraocular lenses with Tecnis multifocal ZM900 intraocular lenses. Rodrigo.

Post-Operative Management of Vitreous Adhesion after DSAEK with YAG Laser Vitreolysis Sherif Idris 1, Ahmed Al-Ghoul 2 MD FRCSC DipABO 1 University of.

Investigation of Multifocal Toric IOLs to Compensate for Corneal Astigmatism and to Provide Near, Intermediate, and Distance Vision José L. Rincón, MD.

Correlation of Visual Outcome and Patient Satisfaction with Preoperative Keratometry in Hyperopic LASIK Patients L. Espandar ; M. Moshirfar; L. B. Williams;

Dissatisfication After Multifocal Intraocular Lens Implantation in Taiwan Yu Wei Lin, MD (Presenting Author); Ching-Ju Hsieh; Lin-Chung Woung The authors.

Long-term results of Phakic Refractive Lens (PRL™) implantation in high myopic eyes. Ioannis G. Pallikaris 1, 2, MD, PhD, Maria I. Kalyvianaki 1, MD, PhD,

Pseudoexfoliation syndrom and cataract: results and complication frequency in immature and mature cataract surgery Marijana Bilen Babić Department of.

Late In-the-bag Intraocular Lens Dislocation:

Eun Chul Kim, M.D. , Man Soo Kim,M.D.

Postoperative Refraction and Patient Satisfaction after Bilateral Implantation of Presbyopia-Correcting Intraocular Lenses Robert Cionni, MD Financial.

Hayashi Eye Hospital, Fukuoka, Japan

B. Kozomara, E. Potkonjak, R. Lazic, N. Gabric

Rengaraj Venkatesh, MD, Colin S. H

Wavefront Optimized Retreatment after Prior Wavefront

Tamer M. El-Raggal, MD, PhD, FRCSEd Magrabi Eye Hospital, Cairo

University of Florence Oto-Neuro-Ophthalmological Department

Early Experience with Descemet’s Stripping Automated Endothelial Keratoplasty Combined with Phacoemulsification: Clinical and Refractive Outcome University.

Clinical results of the aphakia correction using iris-fixated anterior chamber intraocular lens (Artisan) Authors have no financial interest Luis Izquierdo.

Long Term Clinical Outcomes of Refractive Lens Exchange in Moderate to High Hyperopia Frank Goes, BELGIUM Ascrs 2008.

Naval Medical Center, San Diego

Barry A Schechter, MD Florida Eye Microsurgical Institute

Nathalie M. Guibord,MD Geisinger Medical Center

The authors have no financial interest

Visual Outcomes and Satisfaction with Toric IOL Versus Monofocal IOL

Long term PCO preventive effect of capsular bending ring

Presentation transcript:

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Eric C. Amesbury MD Kevin M. Miller MD The authors have no financial interest

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION

Purpose: To report the safety and efficacy of piggyback IOL implantation for residual hyperopia following cataract extraction and diffractive multifocal IOL implantation

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Methods: Case Report  61-year-old male  Right eye phaco with in-the-bag multifocal IOL (AcrySof ReSTOR), 20/50 and J1 uncorrected acuity  sphere  20/20; patient satisfied with spectacles (20/20 cataract left eye)

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Methods (continued):  3 years later: Left eye phaco with multifocal IOL (ReSTOR), 20/15 and J1 uncorrected acuity  Right eye symptomatic with blur and ocular imbalance uncorrected  diopter 3-piece, rounded-edge silicone piggyback IOL (Staar AQ5010V) implanted in the ciliary sulcus of the right eye

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Results:  No intraoperative complications  20/15 and J1 uncorrected acuity  Mild pigment dispersion at 2 weeks postop with 30mmHg IOP

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Results (continued):  Aqueous suppressant + prednisolone acetate 1% therapy controlled IOP  Pigment resolved at 1 month postop  Off all meds with normal IOP and no pigment dispersion at 3 months

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Discussion: Piggyback IOL advantages vs. other options Piggyback Advantages Better patient satisfaction than corrective contact lens or spectacles Avoids induced aberration, other risks of H-LASIK/PRK Less risk of incorrect IOL power, capsular rupture, vitreous loss, CME vs. IOL exchange 1,2

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Discussion (continued): Piggyback IOL Possible Complications: Intraoperative ComplicationPostoperative Complication Capsular Rupture Zonular Dehiscence Vitreous Loss Inflammation/Pigment Dispersion 3 Infection Ocular Hypertension 3 Optic Capture 4 Interlenticular Opacification 5 * Hyperopic Shift (Late) 5 * *Avoided with sulcus piggyback and in-the-bag primary IOL

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Discussion (continued): Alternatives to Piggyback IOL:

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION Conclusion:  Piggyback lens implantation is a safe and effective option for treating hyperopia following multifocal IOL in the short term  Pigment dispersion may be a cause for concern in the long term  Corrective lens, H-PRK/LASIK, IOL exchange options have separate advantages/disadvantages to consider

PIGGYBACK LENS AFTER MULTIFOCAL IOL IMPLANTATION References: 1.Jin JC, Crandall AS, Jones JJ. Intraocular lens exchange due to incorrect lens power. Ophthalmology 2007; 114: Hill, WE. Refractive enhancement with piggybacking IOLs. In: Chang DF, editor. Mastering refractive IOLs: the art and science. Thoroughfare, NJ: Slack Inc.; 2008, pp Iwase T, Tanaka N. Elevated intraocular pressure in secondary piggyback intraocular lens implantation. J Cataract Refract Surg 2005; 31: Gayton JL, Sanders V, Van Der Karr M. Pupillary capture of the optic in secondary piggyback implantation. J Cataract Refract Surg 2001; 27: Gayton JL, Apple DJ, Peng Q, et al. Interlenticular opacification: clinicopathologic correlation of a complication of posterior chamber piggyback intraocular lenses. J Cataract Refract Surg 2000; 26: Qazi MA, Roberts CJ, Mahmoud AM, Pepose JS. Topographic and biomechanical differences between hyperopic and myopic laser in situ keratomileusis. J Cataract Refract Surg 2005; 31: Freedman KA, Brown SM, Mathews SM, Young, RSL. Pupil size and the ablation zone in laser refractive surgery: considerations based on geometric optics. J Cataract Refract Surg 2003; 29: Jin JC, Crandall AS, Jones JJ. Changing indications for and improving outcomes of intraocular lens exchange. Am J Ophthalmol 2005; 140: Marques FF, Marques DMV, Osher RH, Freitas LL. Longitudinal study of intraocular lens exchange. J Cataract Refract Surg 2007; 33: