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Thank God, I’m a Retinal Surgeon

Introduction: The anterior and posterior segments are well-demarcated territories of the eye, with surgical specificities of their own. Sub-specialization in Ophthalmology led to the differentiation of surgeons who operate exclusively in the anterior segment, as well as others who dedicate themselves to the posterior segment. Not infrequently, the anterior segment surgeon comes across circumstances in which the ability to work in the...

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The MST IOL Cutter: My Revolution?

For many years, cataract surgery is performed earlier with the associated risks of zonular trauma during surgery or of an aging/glistening of these implants. Moreover, with the recent tendency to put some multifocal intra-ocular lenses that are not always easily tolerated by the patients, we are frequently asked to replace an IOL. However, since IOL cutters are made of one unique piece of scissor that causes a partial shift of the IOL,...

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Are MT4 Anterior Chamber Implants from Alcon an Acceptable Option to Correct Vision Following Loss of Zonular Support?

In complicated cataract surgery, loosing zonular support, makes it difficult to implant an intraocular lens. In this instance, an intraocular lens needs to be inserted in the anterior chamber or fixated to the iris or the sclera. Unlike scleral fixation, which is a complex procedure and is difficult to reproduce, iris-claw implants and anterior chamber implants are both easier to perform and tend to have a more reproducible final...

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Artisan Forceps: Surgeon’s Best Friend?

Background: The Artisan® forceps (DO2-70, Ophtec BV, Groningen, Holland) is a tool that, due to its versatility, has become one of our secret weapons in several procedures in the operating room. This titanium instrument has an opening range of 6 mm, 10 mm length, a flat surface and a bent tip with striations and wings, to enhance and secure the grasp. It was designed to aid in the implantation of iris-claw anterior chamber intraocular...

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Retropupillary Iris-claw IOL: Still a «Gold Standard» in MIVS Era

Purpose:  To report the long-term outcome of the use of retropupillary implantation of the Artisan iris-claw intraocular lens (RPICIOL) in several aphakic conditions without capsular support. Method: This is a retrospective analysis of 320 consecutive eyes of 320 patients (222 males and 98 females) without capsular support in whom we performed RPICIOL implantation. Aphakia was associated with trauma (n=141 eyes, group 1), post-cataract...

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Intrascleral 3-piece IOL Fixation in Combined RD Cases

Purpose: To report the results of intrascleral IOL fixation in patient who had lens lunation combined with retinal detachment (RD) surgery. Methods: Forty-seven eyes of 47 patients with a diagnosis of RD combined with lens luxation were enrolled into this prospective non-randomised study. Pre- and postoperative standard ophthalmic examination was performed in all patients. Surgery included either phacoemulsification or phacofragmentation...

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My Experience with Sutureless Scleral Fixation IOL as a Fellow

Purpose: To present my experience with Sutureless Scleral Fixated intraocular lens (SSF IOL) during 2 years of retinal surgery fellowship between November 2013 and November 2015). Method: Sutureless scleral fixation of IOL implants involves externalising the haptics of the 3-pieces IOL (MA 50 BM® Alcon, Fort Worth, US) for fixation either within limbal scleral tunnels and or underneath scleral flaps. Two ab-externo sclerotomies are...

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Lenses with Personality

Introduction: Older age and blunt trauma account for most cases of crystalline or intraocular lens (IOL) subluxation or dislocation. Not uncommonly, the retinal surgeon comes across cases in which the lens explant does not seem as easy as expected. Purpose: We report our experience with crystalline and intraocular lens implant removal. Material & Method: This is a retrospective assessment of the surgical records from five patients...

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Transscleral Fixation of IOL in Cases Without Capsular Support

Purpose: To report the results of a technique of sutureless intrascleral fixation of a three-piece foldable hydrophobic acrylic posterior chamber intraocular lens (PC IOL) in the absence of capsular support. Technique: The foldable hydrophobic acrylic three-piece IOL is inserted through a conventional sub-2.8mm clear corneal incision and haptic are fixated into scleral tunnels at the limbus. This technique is suitable for cases of iris...

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Secondary IOL Implantation in the Absence of Proper Bag Support

Proper fixation of IOL is not only the must as far as visual outcome is concerned. Properly fixated IOL is necessary to establish stable condition for future tamponade when the vitrectomy is needed. There are several option available when secondary IOL is needed and there is lack of capsule. The IOL may be sutured to the sclera but prolene 10, 0 suture remains less stable during time . IOL may be fixated to the sclera but this requires...

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Secondary Intrascleral IOL Implantation According to Schariot Technique

The technique first described by Schariot shows the possibility of a secondary system of IOL folding with prolene lens without stitches and inserting the loops into a scleral tunnel. Such a technique is useful both to reposition the folding IOL with prolene dislocated lens and without having to remove the lens from the bulb, that is the closed eye technique. Its also useful for secondary system usin g these types of lenses by inserting...

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Early Clinical Outcomes of Transcleral Fixation of Single-piece Foldable Acrylic Lens (enVista) with Eyelets Located at the Optic-haptic Junction

Yong-Sok Ji_SCIENTIFIC POSTER 2015 Purpose: To report the clinical outcomes of transcleral fixation using a single-piece foldable acrylic intraocular lens (IOL) with eyelets at the optic-haptic junction (enVista, Bausch & Lomb). Methods: Patients who underwent transcleral fixation with an enVista IOL were reviewed. Preoperative patient status, postoperative visual and refractive outcomes, and postoperative complications were...

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Simple Sutureless Intrascleral Fixation Technique of PC IOL

SCIENTIFIC POSTER_Daeyune Kim Purpose: We introduce a new technique for intrascleral fixation of posterior chamber intraocular lenses (IOL) when there is insufficient or no capsular support. Methods: Two scleral grooves were created by making two scleral incisions at 2.0mm from the limbus exactly 180 degrees apart. Within the scleral groove, a sclerotomy was conducted using a 25-gauge microvitreoretinal blade. At the end of the scleral...

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Transscleral Fixation of Foldable IOL

Aphakia is a very common disorder in ophthalmology. It may correlate with ocular trauma, complicated cataract surgery or with hereditary diseases. This video shows a very simple and fast method of transscleral fixation of foldable lenses with small corneal incision and intra scleral hiding of sutures (Z – sutures). To avoid problems with central fixation of IOL caused by vitreous, 25G pars plana vitrectomy is performed. The operation...

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Posterior Iris Claw Implantation for Correction of Aphakia : Technique and Long-term Results

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Purpose: To evaluate the indications, the safety, and the results of retropupillary implantation of iris claw intra ocular lenses in the correction of aphakia Patients and methods: This retrospective study included 50 eyes of 50 patients who underwent retropupillary iris claw IOL fixation between January 2010 and January...

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Secondary IOL Implantation in the Transconjunctival Era. MAY WAY. From Simplest to Hardest WAYS: ACROBATICS

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Purpose: To demonstrate the use of iris-claw posterior IOL (Artisan, Ophtec) implantation combined with transconjunctival vitrectomy surgery system. Methods: In this presentation, we will present different clinical situations where iris claw IOL was used, ranging from the simplest ones to those in which significant damage of the iris...

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Sutureless Scleral Fixation of IOLs in Vitrectomized Eyes

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Objective: To report the clinical outcomes of sutureless scleral fixated Intra ocular Lens (IOL). Design: Case series. Participants: 10 eyes of 10 patients were included in this study. Intervention: Patients underwent sutureless scleral fixated IOL, with intrascleral tucking of haptics, into a tunnel made using 20 G microvitreoretinal...

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Secondary Foldable IOL Knotless Scleral Fixation

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   We will be presenting on knotless scleral fixation of luxated foldable IOLs and for secondary implantation in aphakic eyes in eyes without zonular support. This technique provides the advantage of avoiding iris manipulations, is perfomed through a small corneal incision and does not require the need to order or stock special IOL types....

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Management of Posterior Dislocated Intra Ocular Lenses by Sutureless Scleral Fixation Using Fibrin Glue

Advantages: Posterior dislocation of an intraocular lens is an uncommon but serious complication of cataract surgery. This may occur intra-operatively or postoperatively due to large posterior capsular defects, weak zonules or trauma. In case of inadequate capsular support these lenses are repositioned by suture fixation or are removed and replaced by an anterior chamber IOL. Suturing of a dislocated IOL to the sclera is technically...

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Sutureless Intrascleral Haptic Fixation as a Mean of Scleral Fixated Intraocular Lens Implantation in Various Vitreoretinal Conditions

Advantages: Intrascleral haptic fixation [ISHF] avoids the complications of using sutures in scleral fixated intraocular lens (IOL), including the breakdown of sutures causing dislocation of IOL, suture erosions and obviates the need to create scleral flaps. In cases of posterior dislocated IOL complex, original 3-pieces foldable IOL can be reused. For cases that required IOL exchange or correction of aphakia, it can be inserted through a...

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Cosmetic IOL in Trauma Cases: Role of Iris Surgery and Endoscopy

http://www.evrs.eu/medias/2008/congress/Cosmetic-IOL-in-Trauma-Cases:-Role-of-Iris-Surgery-and-Endoscopy.flv Cesare Forlini, Paolo Rossini, Antonio Aversano (Department of Ophthalmology, “S. Maria delle Croci” Hospital, Ravenna, Italy), Matteo Forlini (Eye Clinic, University of Modena, Italy) Advantages: Show the combined use of cosmetic scleral-fixed cosmetic IOL, iris surgery and endoscopy in the treatment of post-traumatic aphakia...

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Silicone Oil Removal Associated with Secondary IOL Implantation Under Topical Anesthesia

http://www.evrs.eu/medias/2008/congress/Silicone-Oil-Removal-Associated-with-Secondary-IOL-Implantation-Under-Topical-Anesthesia.flv Gilbert WS Simanjuntak, Jannes F Tan, Helario Hasibuan, Jusuf Wijaya Advantages: To remove the silicone oil tamponade along with secondary intra ocular lens (IOL) implantation under topical anesthesia. Methods: Vitrectomized eyes where the peripheral capsule had been intentionally spared and which had been...

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Management of UGH Syndrom in Eyes Implanted with an Artisan

http://www.evrs.eu/medias/2008/congress/Management-of-UGH-Syndrom-in-Eyes-Implanted-with-an-%20Artisan.flv Jean-Paul Amar Advantages: It is a very easy and safe technique when one needs to practice an explantation of an iris clow lens. Methods: Cutting one leg of the clow allows an explantation without any hard contact with the iris.

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Iris Fixated IOL: Let’s Do Just One Hole

http://www.evrs.eu/medias/2008/congress/Iris-Fixated-IOL:-Let’s-Do-Just-One-Hole.flv Barbara Parolini, Grazia Pertile Advantages: Iris fixated IOL´s are very suitable for secondary lens implantation  in aphakic vitrectomized eyes. Usually the IOLs are implanted performing a superior corneal tunnel plus corneal paracenthesis or secondary scleral accesses. The advantage of the present technique is to make only one corneal...

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Sutureless Intrascleral PCIOL Fixation

Gabor B. Scharioth Advantages: We report a new technique for sutureless fixation of a standard 3-piece intraocular lens in eyes without sufficient capsular support. This technique includes independence from iris changes, the use of  small incisions, no need for extra orders or storage of special IOL´s, less costs, standard IOL calculation formula, excellent centration and no IOL tilt, good long term stability and the option to use...

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New Technique for Refixation of a Luxated IOL

http://www.evrs.eu/medias/2008/congress/New-Technique-for-Refixation-of-a-Luxated-IOL.flv Gabor B. Scharioth Advantages: Less invasive technique to refixate a luxated 3-piece intraocular lens. No need for explantation or suturing, independent from iris changes and capsular support. Methods: Pars plana vitrectomy, design of two 24G ciliary sulcus sclerotomies and   – starting from there –  a 2-3mm long limbusparallel...

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Knotless Transcleral Suture of a One-Piece Acrysof IOL

http://www.evrs.eu/medias/2008/congress/Knotless-Transcleral-Suture-of-a-One-Piece-Acrysof-IOL.flv Angelina Meireles, João Melo-Beirão, Natália Ferreira, Bernardete Pessoa Advantages: Scleral fixation of a foldable IOL through a small clear corneal incision in eyes without zonular support. Methods: In ten eyes of nine patients a single-piece foldable IOL was implanted  through a small clear corneal incision and fixated to the sclera....

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Secondary IOL Implantation in the Transconjunctival Era

http://www.evrs.eu/medias/2008/congress/Secondary-IOL-Implantation-in-the-Transconjunctival-Era.flv Cesare Forlini, Paolo Rossini, Antonio Aversano (Department of Ophthalmology, “S. Maria delle Croci” Hospital, Ravenna, Italy), Matteo Forlini (Eye Clinic, University of Modena, Italy) Advantages: Show the use of iris-claw posterior IOL (Artisan Ophtec) implants, combined with transconjunctival surgery systems. Methods: Since 2002,...

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Repositioning of Dislocated in-the-bag Intraocular Lens

http://www.evrs.eu/medias/2006/videos/Repositioning-of-Dislocated-in-the-bag-Intraocular-Lens.flv Gregg T. Kokame, MD (Honolulu, HI) SYNOPSIS In-the-bag IOL dislocation is now more frequently seen as a late complication of cataract surgery with posterior chamber IOL implantation. If the PCIOL is suitable for repositioning, techniques using scleral fixation sutures developed through the externalization of the haptics through clear corneal...

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The Sling Technique for PCIOL Fixation

http://www.evrs.eu/medias/2006/videos/The-Sling-Technique-for-PCIOL-Fixation.flv Richard M. Feist, MD (Birmingham, AL), Peter A. Nixon, MD (Birmingham, AL), Michael A. Albert, Jr., MD (Birmingham, AL) SYNOPSIS This video shows a simple technique for fixation of displaced posterior lens implants still in the bag or sulcus.

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Combined Pars Plana Vitrectomy and Primary Scleral Fixated Intraocular Lens

Angela Loo, MD (Kuala Lumpur, Malaysia), Alan K. Koh, MBBS (Kuala Lumpur, Malaysia) PURPOSE: To study the efficacy of combined pars plana vitrectomy with primary scleral fixated intraocular lens (IOL). METHODS: A consecutive 6 cases of combined pars plana vitrectomy with primary scleral fixated IOL managed at the University Malaya Medical Centre was reviewed. The indications, presenting visual acuity, complications and outcomes were...

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