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    Premium cataract surgery: Correcting complications and side effects

    Keys to unfolding the specific surgical plan of action

     

    II.             IOL-based complicationsTo view technique for exchanging multifocal lens with cracked haptic, click here.

    These problems can be related to defective IOLs, such as broken haptics and damaged optics, which resulted from a manufacturing issue or from handling before or during surgery (while loading or manipulating the lens). In such cases, an IOL exchange can be performed safely to restore the visual quality.

    Poor vision also can result from a less-than-optimal choice of IOL based on determining the angle kappa, spherical aberrations levels, refractive errors, and corneal irregularities and not matching them with the correct optic of the appropriate IOL.

    Further, the IOL implant often may be incorrect in its emmetropic outcome, in that the patient may be over-corrected or under-corrected with or without associated astigmatism.

    Keeping Corneoplastique principles in mind, the IOL can be exchanged for another properly calculated IOL or a laser surface ablation technique or a piggyback technique performed as previously described in stage-2 surgeries to achieve an optimal optical endpoint. 

    III.           Patient symptomatology and dissatisfaction

    In some cases, patients may not have been adequately educated about and prepared for the visual outcomes, which the surgeon may deem to be perfect. In addition, the surgeons’ anticipated desires and profession-related endpoints and other confounding factors may negatively impact patient satisfaction postoperatively.

    Some patients can be negatively or psychologically affected or unprepared for improper or unexpected endpoints such as glare and halos. They may find relief only with exchange of the IOLs.

    Case scenarios

    Arun C. Gulani, MD
    Dr. Gulani is director of refractive surgery and chief, cornea & external disease, as well as assistant professor, department of ...

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