IOL

1. INTRAOCULAR LENSES
BY
J.BHANU PRATHAP
ROLL NO: 57

2. HISTORICAL ASPECTS
 PRESENT DAY IOLs
 Classification
 Design
 Material
 PREMIUM IOLS
 PHAKIC AND ASPHERIC IOLS
 COMPLICATIONS RELATED TO IOLs
 RECENT ADVANCES AND THE FUTURE

3.  K

4. WHAT IS INTRAOCULAR LENS?
• An artificial lens implanted in the eyes
• Replaces the crystalline lens
• Tocorrect the optical power of the eyes following:-
Lens being
clouded by
cataract
Refractive surgery

5. PARTS OF AN IOL
• OPTIC
Part of the lens that focuses
light on the retina.
• HAPTIC
Small filaments connected to the optic
that hold the lens in place in the eye
HAPTEN
OPTIC

6. PARTS OF AN IOL
• OPTIC
Part of the lens that focuses
light on the retina.
• HAPTIC
Small filaments connected to the optic
that hold the lens in place in the eye
HAPTEN
OPTIC

7. PARTS OF AN IOL
• OPTIC
Part of the lens that focuses
light on the retina.
• HAPTIC
Small filaments connected to the optic
that hold the lens in place in the eye
HAPTEN
OPTIC

8. CLASSIFICATION

9.  FIRST GENERATION IOLS

10. SECOND GENERATION IOLS
 Rigid and semi-rigid anterior chamber IOLs
 the anterior chamber, with fixation of the lens in the angle recess
 Baron, in France, is generally credited as being the first designer and implanter of
an anterior chamber lens
ADVANTAGES
• Less decenteration
• Decreased reaction
DISADVANTAGES
• Corneal decompensation
• Pseudophakic Bullous
keratopathy
• Uveitis
• Secondary glaucoma

11. THIRD GENERATION IOLS
 Iris suppoted lens
 Cornelius Binkhorst, Iris clip lens; four-loop (1957)
 Iridocapsular fixation; two loop (1965)
ADVANTAGES
• Away from angle structures
• Rate of dislocation was less
• Less contact with corneal endothelium
DISADVANTAGES
• Iris chaffing
• Pupillary distortion
• Transillumination defects
• Chronic inflammation
• CME
• Distortion on pupillary dilatation
• Endothelial decompensation

12. FOURTH GENERATION IOLS
 Intermediate ACIOL
 Flexible loops with multiple point of fixation
 More stable
 Advantages – more stable, better design, less complications
 Disadvantages – anterior chamber is not the physiological site for IOL

13. FIFTH GENERATION IOLS
PMMA lenses Rigid posterior chamber IOL
Sixth generation IOLs
Foldable IOL
Seventh generation IOLs
Multifocal IOL
Eighth generation IOLs
Accomodative IOL
Phakic refractive IOL

14. COMPLICATIONS OF
CATARACT SURGEY

15. CLASSIFICATION
 Complications of anesthesia
General anesthesia
Regional / Local anesthesia
 Intraoperative
 Early postoperative
 Late postoperative

16. ANESTHESIA
COMPLICATIONS
REGIONAL ANESTHESIA

17. PERIBULBAR / RETROBULBAR ANESTHESIA
 Lids trauma (ecchymosis)
 Ptosis
 s/conj hemorrhage
 Muscles damage
 Globe penetration & its related complications
 Retrobulbar hemorrhage
 Optic nerve damage
 Putscher-type retinopathy *
 Brainstem anesthesia

18. RETROBULBAR HEMORRHAGE
 Common complication
 Causes proptosis & raised IOP
 Incidence of severe RBH = 0-3%
 Reported case of CRAO *
 Management
 Continue with surgery if minimal
 Lateral canthotomy for severe cases