Polypseudophakia with Captured Optics
To demonstrate the use of advanced technology to successfully complete cataract surgery and implant 2 intraocular lenses in an eye with high axial myopia and high corneal astigmatism.
Summary of Content
A patient with high axial myopia and high corneal astigmatism desired an emmetropic outcome from cataract surgery. Optical biometry was modified using calculations based on the work of Wang, et al. The lowest spherical power component of toric lens commercially available was greater than predicted by these calculations. A piggyback set of IOLs was clculated with the Holladay Consultant. The eye received femtosecond laser treatment, and after removal of lens material a PCCC was created. A CTR was inserted to satbilize the capsular bag/IOL complex. A single piece acrylic toric lens was placed with haptics in the bag and the optic captured posteriorly with orientation in the proper meridian for astigmatic correction. A 3-piece lens was placed with haptics in the sulcus and optic captured through the anterior capsulotomy. The patient achieved uncorrected vision of 20/20. This configuration of IOLs maintains centration of the 2 lenses relative to each other and to the visual axis. The convex surface of the toric lens placed against the concave surface of the piggyback lens will reduce any optical changes by this contact, and the optics are separated by the posterior capsule thus reducing the chance of interlenticular opacity. Given the low power of IOLs used, any deviation of axial position from predicted would have reduced refractive effect.
[ Keyword ]
myopia / astigmatism / optic capture / posterior capsulorhexis / femtosecond laser
[ Conflict of Interest ]