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

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Presentation transcript:

Phakic posterior chamber IOLs 1.Cells involved in crystalline lens and capsular bag opacification 2.Evolution of designs of PPCIOLs 3.Relevant aspects of fixation and sizing 4.Sizing issue: New studies 5.Surgical implantation 6.Relationship between cataract and myopia 7.Cataractogenesis Specimens analyzed in our Center Mechanisms Review of the literature Classification of cataracts after phakic IOL implantation?

White-to-white mm (myopic eyes) White-to-white – 0.5 mm (hyperopic eyes) Third generation: Staar ICL

White-to-white?

Pop M, Payette Y, Mansour M. Predicting sulcus size using ocular measurements. J Cataract Refract Surg 2001; 27: eyes of 24 patients (34 ± 6 years) -Spherical equivalent: to –8.75, and to Measurements: white-to-white with surgical calipers; sulcus diameter with composites of UBM photographs (50 MHz) -Traditional estimation of sulcus size through limbal measurement is inadequate: limbus size alone cannot predict sulcus size

Werner L, Apple DJ, et al. Correlation between different measurements within the eye with relevance for phakic intraocular lens implantation. J Cataract Refract Surg 2002 (in preparation)

No correlation: White-to-white and angle-to-angle (vertical meridian) N = 10 eyes

No correlation: White-to-white and sulcus-to-sulcus (vertical meridian) N = 10 eyes

No correlation: White-to-white and angle-to-angle (horizontal meridian) N = 12 eyes

No correlation: White-to-white and sulcus-to-sulcus (horizontal meridian) N = 12 eyes

Anterior segment B-scan with a high-frequency digital ultrasound system:“ARTEMIS” Developed at the Cornell University by J. Coleman, R. Silverman, and D.Z. Reinstein Manufactured by Ultralink G. Wilserman and S. Phillips

Evaluation of a new ultrasound system for refractive surgery Werner L, et al. Evaluation of a new ultrasound system for refractive surgery. Poster presented at the XX Congress of the ESCRS, Nice, France, September cadaver eyes (9 phakic and 6 pseudophakic) 123 4

Phakic cadaver eye (horizontal meridian)