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Sutured posterior chamber IOL fixation in the absence of capsular support, first described in 1954

Poster Details

First Author: K.Gerstmeyer GERMANY

Co Author(s):    S. Scholtz   G. Auffarth           

Abstract Details



Purpose:

By implanting the first IOL in 1949 Harold Ridley's intention was to replace the opaque crystalline lens with a „lenticulus' exactly the size and the shape of the natural lens in the same physiological location in the posterior chamber. Still not resolved at that time was the fixation of the 'pseudophakos' in the posterior capsule resp. on residues of the anterior capsule following (for example extracapsular cataract surgery). This poster reflects the first attempts in 1954 to improve the centration of IOLs using a suture technique of posterior chamber IOLs.

Setting:

(1) Augenklinik Johannes Wesling Klinikum Minden, Germany (2) International Vision Correction Research Centre (IVCRC), Dept. of Ophthalmology, University of Heidelberg, Germany

Methods:

Selective literature research of books and articles in journals via PubMed, Google Scholar and Google

Results:

Inferior decentration of the Ridley IOL has been an important reason for searching for alleged more suitable options for IOL fixation, e.g. the iridocorneal angle. The conventional opinion is that Pearce (in 1975 in the UK) and Shearing (in 1977 in the US) solved this problem by using posterior chamber IOLs with haptics made of polypropylene. This is not quite correct: In 1954, by using a thin wire anchored in the IOL material, the British ophthalmologist, T. G. W. Parry, managed the first suture fixation of a Ridley IOL in the posterior chamber.

Conclusions:

Besides already established primary and secondary IOL implantation into the posterior chamber, this remarkable innovation opened the way for further pioneering treatment options, some of which were not realized until years later: - Sutured IOLs as stand-by lenses when experiencing intraoperative complications - In case of IOL exchange, e.g. when dealing with bullous keratopathy, damaged IOL or refractive problems - When repositioning decentered IOLs ('out-of-the-bag') and re-fixation of a dislocated capsular bag - IOL complex ('late-in-the-bag') to avoid lens exchange FINANCIAL INTEREST: NONE

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