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Phakic posterior chamber IOLs

Phakic posterior chamber IOLs. Cells involved in crystalline lens and capsular bag opacification Evolution of designs of PPCIOLs Relevant aspects of fixation and sizing Sizing issue: New studies Surgical implantation Relationship between cataract and myopia Cataractogenesis

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Phakic posterior chamber IOLs

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  1. Phakic posterior chamber IOLs • Cells involved in crystalline lens and capsular bag opacification • Evolution of designs of PPCIOLs • Relevant aspects of fixation and sizing • Sizing issue: New studies • Surgical implantation • Relationship between cataract and myopia • Cataractogenesis • Specimens analyzed in our Center • Mechanisms • Review of the literature • Classification of cataracts after phakic IOL implantation?

  2. Third generation: Staar ICL White-to-white + 0.5 mm (myopic eyes) White-to-white – 0.5 mm (hyperopic eyes)

  3. White-to-white?

  4. Pop M, Payette Y, Mansour M. Predicting sulcus size using ocular measurements. J Cataract Refract Surg 2001; 27:1033-1038. -43 eyes of 24 patients (34 ± 6 years) -Spherical equivalent: -25.50 to –8.75, and +4.00 to +7.50 -Measurements: white-to-white with surgical calipers; sulcus diameter with composites of UBM photographs (50 MHz) -Traditional estimation of sulcus size through limbal measurement is inadequate: limbus size alone cannot predict sulcus size

  5. 2 1 3 Werner L, Apple DJ, et al. Correlation between different measurements within the eye with relevance for phakic intraocular lens implantation. J Cataract Refract Surg 2002 (in preparation) 4

  6. No correlation: White-to-white and angle-to-angle (vertical meridian) N = 10 eyes

  7. No correlation: White-to-white and sulcus-to-sulcus (vertical meridian) N = 10 eyes

  8. No correlation: White-to-white and angle-to-angle (horizontal meridian) N = 12 eyes

  9. No correlation: White-to-white and sulcus-to-sulcus (horizontal meridian) N = 12 eyes

  10. Anterior segment B-scan with a high-frequency digital ultrasound system: “ARTEMIS” Developed at the Cornell University by J. Coleman, R. Silverman, and D.Z. Reinstein Manufactured by Ultralink G. Wilserman and S. Phillips

  11. Werner L, et al. Evaluation of a new ultrasound system for refractive surgery. • Poster presented at the XX Congress of the ESCRS, Nice, France, • September 2002 • 15 cadaver eyes (9 phakic and 6 pseudophakic) 1 2 3 4

  12. Phakic cadaver eye (horizontal meridian)

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