How to implant the Retropupillary Iris Claw IOL (ICIOL) for aphakic eyes with no zonular support? скачать в хорошем качестве

How to implant the Retropupillary Iris Claw IOL (ICIOL) for aphakic eyes with no zonular support?

How to implant the Retropupillary Iris Claw IOL (ICIOL) for aphakic eyes with no zonular or capsular support after cataract surgery? Arguably the retropupillary ICIOL can be preferred to anterior fixation. Why? There is no need to do a peripheral iridotomy with the retropupillary position. It mimics a PCIOL in the bag. It’s more aesthetically pleasing. It anatomically sits where the crystalline lens previously sat. There’s protection of the corneal endothelial cells with the retropupillary position. Remember to increase the power of the IOL if placing it posteriorly. For retropupillary placement, the manufacturer-recommended A-constants for the Artisan PMMA aphakic claw IOL using SRK T formula are 116.9 (optical) and 116.8 (ultrasound). For prepupillary placement, the recommended A-constants are 115.7 (optical) and 115.0 (ultrasound). The Artisan ICIOLs are a rigid PMMA design with a 5.4mm optic and 8.5mm length. Read the journal article “Retropupillary Iris-Claw Intraocular Lens (ICIOLs)” in Clinical Ophthalmology 2021 https://pmc.ncbi.nlm.nih.gov/articles... Read another review journal article, “Implantation of retropupillary iris-claw lenses: A review of surgical management and outcomes” published in Acta Ophthalmologica 2021 https://onlinelibrary.wiley.com/doi/1... It’s easy to implant a retropupillary ICIOL. Watch the video by Dr Ahmed Elshafei    • CataractCoach™ 1921: retro iris claw lens ...   The steps are: 1. Full pars plana vitrectomy 2. Make a 5.5 mm main incision 3. Make two paracenteses 4. Inject Miochol (acetylcholine) into the anterior chamber ( AC ),over the superior surface of the iris, (so it doesn’t just go down through the pupil into the vitreous) to bring the pupil down. 5. Check the IOL before implanting that the cuts in the haptic (claws) are patent. 6. Insert the ICIOL into the AC under viscoelastic and rotate it to the horizontal plane 7. Suture the main wound for stability of the AC before proceeding. 8. Grasp the ICIOL with the flat micro forceps and tuck one haptic under the iris. 9. A special enclavation spatula or a thin bent spatula/ blunt needle is introduced via the paracentesis held in the non-dominant hand. 10. Next, the IOL should be tilted up against the posterior iris to visualize the claw configuration, after which the enclavation can be made by inserting the iris tissue into the claw using the spatula. 11. Add more viscoelastic to stabilise the AC. 12. Use the grasping forceps to tuck the opposing haptic underneath the iris. 13. Use the cannula through the opposite paracentesis to enclavate the iris so it sits nicely in the horizontal plane. 14. It’s just a tap with the cannula on top of the break in the haptic against the opposed posterior iris 15. Remove the viscoelastic and administer intracameral antibiotics Now watch the video again    • CataractCoach™ 1921: retro iris claw lens ...   Learn new techniques in Cataract Surgery with the Cataract Surgery System https://stan.store/drdianelesleywebst... Sign up for my free weekly update all about the heuristics of cataract surgery https://stan.store/drdianelesleywebst... #cataractsurgerysystem #cataractsurgerymentor #cataractsurgery #drdianelesleywebster