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SHOW DAILY
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history of keratoconus and slight
asymmetrical astigmatism, under-
went Visian ICL implantation.
However,
postop, the patient experi-
Tuesday, April 29, 2014
ASCRS Symposia
Collamer Lens, STAAR Surgical,
Monrovia,
Calif.).
Jose Beniz, MD, said that his
patient, a female with a family
A case of excessive vaulting, and a cure
by Matt Young EyeWorld Contributing Writer
A
little troubleshooting
resolved the problem of a
case of excessive vaulting of
the Visian ICL (Implantable
enced slight tilt and vaulting of the
lens to 0.96 mm, which was outside
the normal range recommended, Dr.
Beniz
said. This occurred in the right
eye, while the left eye was normal.
The normal recommended
range is between 0.25 to 0.75 mm,
which is the distance between the
posterior surface of the ICL and the
anterior surface of the crystalline
lens, he said.
"I decided to reposition this
lens,
thinking of the malposition
inside the posterior chamber," Dr.
Beniz said. "So I took the patient to
the OR 1 week postoperatively, since
the lens vaulting wouldn't change."
In the OR, Dr. Beniz performed
only slight rotation of the lens,
using slight movement of the foot-
plates and sideport incisions "since
we want the lens in the 3 to 9
o'clock hour position, which is r
ecommended."
"I was not lucky," Dr. Beniz said.
"[Postoperatively] the lens still
experienced excessive vaulting. It
was showing more than 1 mm of
vaulting, still outside the normal
range. I decided then with the
advice of the manufacturer to
exchange the ICL."
The new ICL lens used had the
same power, but a slightly smaller
diameter. The previous one was 13
mm, while the new one used was
12.5 mm.
"You have to be careful not to
excessively manipulate the anterior
segment of the eye," Dr. Beniz said.
"Just perform a slight rotation to the
right position and using the same
initial main incision, reopening it is
very easy. Using forceps, gently
bring the lens out. It is very foldable
and it comes out very easily."
Fill the anterior chamber with
viscoelastic and then implant the
second lens, Dr. Beniz said. Implant
it very slowly into the eye. Again, he
placed the lens into the 3 to 9 o'-
clock hour position
"Sometimes we do a temporal
incision, but I decided to perform a
superior incision because the patient
had a with-the-rule astigmatism,"
Dr. Beniz said. He used the foot-
plates in the correct position.
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continued on page 16
