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Altan A. Ozcan, MD
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This video demonstrates the management of a symptomatic dislocated posterior chamber IOL, with a Siepser slipknot suture technique.
Posted: 4/13/2020
Altan A. Ozcan, MD
This video demonstrates the management of a symptomatic dislocated posterior chamber IOL, with a Siepser slipknot suture technique.
Posted: 4/13/2020
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Just Now
Anonymous
5 months ago
Altan Atakan Ozcan
1 year ago
Thanks for the comments. I totally agree with Dr.Safran and share the same concerns. I showed this video for an alternative method where scleral fixation is not preferred. For sure I recommend this thechnique especially with 3 piece or PMMA IOLs as in this case.
Marco Alberti
2 years ago
I used this methodology some times and despite the comments made by other doctors I believe that in many cases this is the less risky way to manage a dislocated iol . Cutting a lens and implanting a new lens can also be as dangerous as fixing the old lens to the iris, of course better if the lens is a 3 pieces iol .
Anonymous
2 years ago
Could 27G needles be used for this technique? Thank You.
Guy Hunter
2 years ago
This seems like an awful lot of effort for a less-than-ideal outcome; as above, there's plenty of evidence to suggest that suturing a PC IOL to the iris could cause complications. In addition, mobilising the lens to the AC and removing it from the eye before replacing it with a purpose built AC IOL of your choice is technically easier, quicker and less prone to complication...
Steve Safran
2 years ago
I would not recommend suturing a single piece acrylic intraocular lens to the iris. I think this puts the patient at a very high risk of iris chafing and UGH syndrome over time. If a dislocated single piece IOL is completely within the bag it is reasonable to lasso the complex to sclera but always when doing these manipulations it is important to avoid dragging on vitreous and creating vitreous traction....including to structures within the eye like iris or sclera. In general I am not a fan of iris fixation of intraocular IOLs as the iris is a richly vascular, highly innervated and sensitive tissue and when it is irritated it can lead to inflammation, CME, pain and when you suture IOLs to iris you can get phacodonesis that can cause optical issues for the patient. I've seen many patients on referral in which over time the sutures cheesewire or break and the lens falls back on the retina so I personally do not perform or recommend iris fixation of IOLs but particularly for a single piece IOL I think this should be contraindicated.
Altan Atakan Ozcan
2 years ago
Steven Siepser
3 years ago
Thank you for the recognition! It is nice to see this technique done so well and helping you and your patients. Steven Siepser, MD, FACS
fersat muhacir
4 years ago
A perfectly managed surgery, congratulations.
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