![]() ![]() iridocyclitis (in the near postoperative period).The patient lost one line of BCVA and has poor contrast sensitivity.To date, we have seen only one case of subcapsular opacity 13 months after surgery.Keep an IOL ready in the OR with all IOL power calculations done in advance.Be ready to convert the procedure to phacoemulsification for crystalline lens extraction with IOL implantation.We observed no recurrence of pupillary block.We surgically enlarged the iridectomy, which relieved the pupillary block.Pupillary block was observed in one eye 3 weeks after insertion of a second generation lens.Two weeks postoperatively, the IOP was within normal limits (≤ 17 mmHg) for all four cases.All four cases were treated topically with timolol maleate 0.5% ophthalmic drops and Diamox.We have witnessed four cases of increased IOP (21-27 mmHg) at the 1- week postoperative visit.Administer beta-blocker drops until the IOP is normalized.Reabsorb the residual viscoelastic in the chamber by administering Diamox (≤ 1.0 g/day) and keeping the pupil dilated.Make the iridectomy bigger or create an additional one (perhaps with a YAG laser) if it is small or closed.Check the patency of the iridectomy by testing the visual and red reflex.On slit-lamp examination the chamber may be shallow, the pupil doesn’t react to light or is sluggish, residual viscoelastic is in the AC or PC, and the gap between the PRL and anterior capsule is larger than normal.The patient feels pain in the eye and complains of vision loss or headache in the temple.a shallow AC ( 30 mmHg) on first or second day postoperatively.Preoperative Refraction in Study Population replacement of earlier model of the PRL (2 cases of dislocation).refractive errors (2 cases) from radial keratectomy (RK), photorefractive keratotomy (PRK), and laser in situ keratomileusis (LASIK).keratoconus with a high myopic component (1 case).scleral reinforcement surgery recommended for progressive myopia.unilateral high myopia with amblyopia in children (7 cases see Pediatric Usage).−4.00 to −25.00 D (future treatable errors).−6.00 to −23.00 D (present treatable errors).Here we analyze clinical data for 122 implants in 72 patients (aged 9-53 years), which were collected in our day-hospitals in Milano and Bari, Italy, since 1994.įigure 17-3 Overall design of the latest model of the silicone Russian PRL. The remainder of this chapter discusses our experience with second- and third-generation IVI Medennium PRLs (Fig. pigmentary glaucoma (potential, not seen).decentration in the earlier, smaller models (most common complication but not observed after changing the size parameters of the PRL in successive generations).hyperopia (+3.0 to +15.0 D but correction possible for ≤ +23.0 D).no contact between lens and anterior capsule of the crystalline lens.implantation easy through a 3.0- to 3.5-mm clear corneal incision. ![]() OZ diameter = 4.5 to 5.5 mm (depends on the optic power of the lens).Number of Implants per Generation of Medennium PRLs We have implanted 483 Medennium lenses (three generations) since 1987 ( Table 17-1). Federal Drug Administration study application is now in progress. (originally in Cincinnati, OH, but now in Irvine, CA), produces the PC PRL that we have been using for the past 6 years. helps to increase uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA)įigure 17-1 An example of the Mushroom model.įigure 17-2 First model PRL with pupillary capture.helps to achieve immediate and stable refractive effect.not expensive for the doctor or patient.intended for implantation in the PC laying on the zonular fibers.This lens was the prototype of all other PC PRLs that are available today ( Fig. The first PRL consisted of a completely new nontoxic silicone material that had a higher refractive index than the previous Mushroom model (named after its mushroom shape visible on cross section) and was completely different in its configuration, parameters, and mechanism of fixation (the Mushroom model was pupil fixated Fig. The concept of a purely posterior chamber (PC) phakic refractive lens (PRL) originated in the former Soviet Union. Experience with the IVI Medennium Phakic Intraocular Lens
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