CataractCoach™ 2665: how to reposition a Toric IOL скачать в хорошем качестве

CataractCoach™ 2665: how to reposition a Toric IOL

Repositioning a toric intraocular lens (IOL) is indicated when postoperative rotation leads to suboptimal astigmatic correction, typically beyond 10 degrees from the intended axis. Timing is critical—ideally, repositioning should be performed within 1 to 2 weeks postoperatively, before capsular fibrosis stabilizes the IOL. It can be done later, as shown in this case, with careful dissection of the IOL from the capsular bag. The anterior chamber is re-inflated with a cohesive ophthalmic viscosurgical device (OVD) to protect the corneal endothelium and separate the IOL from the capsular bag. The main wound may be reopened, and a second instrument is used through the side port to gently dial the IOL into the correct axis, as confirmed by preoperative planning and intraoperative axis markings Rotational manipulation should be done cautiously to avoid zonular stress or capsular tears. Once aligned, all OVD—especially behind the IOL—is meticulously removed to reduce the risk of postoperative rotation. The wounds are checked for integrity, and intraocular pressure is normalized. Postoperative follow-up includes monitoring IOL position and refractive outcome. If significant rotation recurs, options include IOL exchange or suture fixation. Early intervention typically results in excellent visual and refractive outcomes.