2020–2021 BCSC Basic and Clinical Science Course™
11 Lens and Cataract
Chapter 12: Preparing for Cataract Surgery in Special Situations
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.