IOL Selection After Trauma
The clinician tailors the lens implant to the patient’s ocular anatomy and to the desired postoperative outcome. In patients with a history of uveitis, hydrophobic acrylic IOLs are preferred to silicone lens implants because vision-impairing inflammatory debris is more likely to collect on the surface of silicone lens implants (see Fig 12-11). Silicone lens implants are also preferred in eyes that are likely to undergo vitreoretinal surgery in the future. In eyes that have more than 4 clock-hours of inadequate zonular support but an intact anterior capsule, a 3-piece posterior chamber lens may be placed in the ciliary sulcus. If there is no capsular support, a 3-piece lens may be fixated to the scleral wall. AC lenses are designed to be sufficiently flexible for open-angle glaucomatous eyes. Ultimately, the choice of IOL is determined by the surgeon’s experience with lens options and implantation methods.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.