Tamer M. El-Raggal, MD, PhD, FRCSEd Magrabi Eye Hospital, Cairo

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Presentation transcript:

Tamer M. El-Raggal, MD, PhD, FRCSEd Magrabi Eye Hospital, Cairo 2ry piggyback IOL exchange LASIK for correction of ametropia after cataract surgery Tamer M. El-Raggal, MD, PhD, FRCSEd Ain Shams University Magrabi Eye Hospital, Cairo Egypt No financial interest

Introduction - A-scan errors (in patients with long eyes) & lack of Causes of refractive surprise after cataract surgery - Mistakes in corneal measurements after RS. - A-scan errors (in patients with long eyes) & lack of precision in patients with short eyes. - Human error. - Mislabelling or inversion of implanted IOL. Solutions to this situation: (1) Spectacle (2) CL (3) Surgery - 2ry piggyback IOL - Exchange of original IOL - Laser correction. El-Raggal, T ASCRS, 2009

Patients& Methods Myopic refractive error: By Holladay. Prospective comparative study included: 15 pseudophakic eyes of 13 patients: - 11 myopic residual refractive error - 4 hyperopic error. Group 1: 5 eyes ----- 2ry piggyback, foldable acrylic IOL in sulcus. Group 2: 5 eyes ---- IOL explantation with implantation of another. Group 3: 5 eyes ----- Customized LASIK using Visx Star S4. Piggyback IOL power Myopic refractive error: By Holladay. Power of IOL = 1.0 D of desired SE change. Hyperopic refractive error: By Gills. Power of IOL = [1.4 X desired SE change] + 1 D. El-Raggal, T ASCRS, 2009

Results Mean age at time of surgery 57.08 ± 5.19 yrs (range 48 to 67 years). Refractive procedures performed at mean of 167.3 ± 188.1 d (range 3 to 540 d) after cataract extraction. Complications Group 1: None Group 2: 1 Posterior capsule rupture+ vitreous loss ----- anterior vitrectomy+ sulcus implantation Group 3: 2 epithelail defect ---- heald El-Raggal, T ASCRS, 2009

Group 2 Group 3 Group 1 El-Raggal, T ASCRS, 2009

Conclusion IOL exchange safe in high error with early intervention after cataract surgery. Piggyback implantation is safer in delayed intervention. LASIK has advantage over other 2 procedures in correction of astigmatism. Piggyback 2ry IOL, IOL exchange & LASIK safe, effective & predictable options for correction of errors following cataract. Although LASIK is non-invasive alternative, final UCVA not as high as in virgin eyes. El-Raggal, T ASCRS, 2009

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