Concise form of the various types of implants currently existing in the realm of Ophthalmology

1. PRESENTER : DAISY VISHWAKARMA
POST – GRADUATE STUDENT
DEPTT. OF OPHTHALMOLOGY
AMCH

2. TABLE OF CONTENTS
1. INTRODUCTION
2. EYELID IMPLANTS
3. CORNEAL IMPLANTS
4. IMPLANTS FOR GLAUCOMA SURGERY
5. INTRAOCULAR LENSES
6. CAPSULAR TENSION RINGS
7. DRUG DELIVERY FOR POSTERIOR SEGMENT
8. RETINAL IMPLANTS
9. ORBITAL IMPLANTS
10. IMPLANTS FOR ANOPHTHALMIC SOCKET &
ORBITAL WALL
11. IMPLANTS FOR LACRIMAL SYSTEM
12. RECENT ADVANCES

3. IMPLANT
An implant is an object or material
that is inserted or grafted in the body
for certain specific purposes.
IDEAL IMPLANT :
 Environmentally stable
 Easy to insert & manipulate
 Bio-compatible
 Non-toxic & Non-carcinogenic
 Should not arouse fibrous tissue formation
 Reasonably priced.

4. EYELID IMPLANTS

5. • Used to restore closure of the lid in
severe cases of symptomatic
lagophthalmos.
• TYPES :
• Gold
• Platinum
• Bismuth
• Weight adjustable
magnet
• The implants are inert & composed
of 99.99% pure gold or platinum.
EYELID IMPLANTS

6. • Weight ranges from 0.6- 1.8 gm.
• COMPLICATIONS :
 Migration of the implant
 Inflammation
 Bulging
 Astigmatism
 Pseudoptosis
 Allergic reaction
 Extrusion.

7. CORNEAL IMPLANTS

8.  KERATOPROSTHESIS
 INTRA-CORNEAL RING SEGMENTS
CORNEAL IMPLANTS

9. KERATOPROSTHESIS
Artificial cornea used in patients not managed
with conventional keratoplasty.
INDICATIONS:
 Steven Johnson syndrome with
keratinization
 Ocular cicatrical pemphigoid
 Severe chemical injury
 B/L stem cell loss or deficiency
 Severely vascularised recipient eyes
 Multiple previous failed corneal grafts

10. CLASSIFICATION :
NON-BIO INTEGRATED: DOHLMAN
(BOSTON) K-pro
(nut & bolt design)
SINGH- WORST K-pro
(champagne cork K-
pro)
BIO- INTEGRATED: MOOKP
PINTUCCI Kpro
ALPHA-COR

11. NON-BIO INTEGRATED
PMMA cylinder is placed in cornea through a central
opening
COMPLICATIONS:
 Prob with integration with cornea
 Leaks around cylinder
 Retroprosthetic membrane (RPM)
 Raised IOP
 Infectious endophthalmitis
 Sterile vitritis
 RD & Vit Hem (rare)

12. NON- BIO INTEGRATED IMPLANTS
BOSTON K-pro SINGH- WORST K-pro

13. First implanted in soft subcutaneous tissues of the
patient’s malar region to develop a soft tissue
cover, then used to integrate them with ocular
surface of eye.
BIO- INTEGRATED

14. BIO- INTEGRATED
COMPLICATIONS:
 Ocular – corneal /globe perforation
 inflammation
 glaucoma
 continuation of primary disease
process
 OOKP lamina resorption
 Oral – oro- maxillary fistula
 Buccal mucous memb infection
 Palatal/ lingual bone #

15. Pintucci K-
Pro
MOO K-Pro
ALPHA-COR (intracorneal)
BIO -INTEGRATED IMPLANTS

16. INTRA-CORNEAL RING SEGMENTS
ICR are semicircular PMMA devices
implanted into the corneal stroma causing an
alteration in its curvature & leading to a
change in its refractive power.
 PRINCIPLE: When vol is added to corneal
periphery or removed from centre, it leads to
flattening of the central cornea reducing
corneal power.
 INDICATIONS :
 Myopia
 Keratoconus & other ectatic
corneal disorders

17. TYPES :
1. FERRARA RINGS
2. INTACS
3. BISANTIS SEGMENTS
4. MYORING

18. INTACS :
• 2 PMMA pieces
• Hexagonal in cross-
section
• Arc of 150°
• Diam: ext. – 8.1 mm
int. – 6.7 mm
• Thickness : 0.25 – 0.4 mm
• Recently , a new INTACS
segment ( INTACS SK )
design with inner diam. of
6mm & oval cross – section in
shape was produced.

19. ADVANTAGES
 Reversible procedure
 Centre of cornea
spared
 No ablation of
corneal tissue
 No induced
weakness of cornea
COMPLICATIONS
 Improper centration
 Too shallow or deep
insertion
 Corneal perforation
 Infectious keratitis
 Segment
displacement
 Segment exposure
 Corneal melt
 Corneal scarring
 Deposits around

20. IMPLANTS FOR GLAUCOMA
SURGERY

21. IMPLANTS FOR GLAUCOMA SURGERY
GLAUCOMA DRAINAGE
IMPLANTS
Drainage implants were developed
to enhance trabeculectomy
surgery.
Artificial devices that work by
creating an alternate pathway
for aqueous outflow by
channeling aqueous from
anterior chamber through a tube

22. CLASSIFICATION :
 NON- VALVED DEVICES/ NON-
RESTRICTIVE :
 single plate Molteno implants
 Baerveldt implant
 Schocket encircling tube
 Ex-PRESS R50 shunt
 VALVED DEVICES/ RESTRICTIVE:
 Ahmed glaucoma valve
 Krupin slit valve
 Joseph- Hitchings device
 GDD WITH VARIABLE RESISTANCE :
 Molteno dual ridge device
 Baerveldt bioseal
 SOLX Goldshunt Baerveldt
single plate Molteno implan

23. Ahmed GV FP-
7
Ahmed GV S2 Ahmed GV B1
double plate
Molteno dual plate ridge

24. INDICATIONS:
 Neovascular glaucoma
 PK with glaucoma
 RD Sx with glaucoma
 ICE syndrome
 Traumatic glaucoma
 Uveitic glaucoma
 OAG with failed
trabeculectomy
 Epithelial down growth
 Refractory infantile
glaucoma
 CL wearers who need
glaucoma filtration Sx
Ahmed GDD
Baerveldt GDD

25. CONTRA-INDICATIONS:
Eyes with severe scleral or
sclera-limbal thinning
Extensive fibrosis of conjunctiva
Ciliary block glaucoma
RELATIVE
CONTRA-INDICATIONS:
Vitreous in AC
Intra-ocular silicone oil-implant
if required is placed infero-
temporal quadrant

26. POST- OP COMPLICATIONS:
 Hypotony/ choroidal
detachment
 Tube obstruction
 Elevated IOP
 Overhanging bleb
 Bleb encapsulation
 Tube exposure/
migration/extrusion
 Tube retraction
 Corneal
endothelial touch
 Ocular motility
disturbance
 Suprachoroidal
hemorrhage
 Corneal graft
failure
 Endophthalmitis
 Loss of vision

27. THE EX-PRESS GLAUCOMA
SHUNT:
 Recently introduced
 Both as primary procedure
or when conventional
therapy fails
 Made of stainless steel
 3 mm long tube
 External diam : 400µ
 Inner diam : 50µ
 Used under a scleral flap.

28. MIGS
 Indications- patients with glaucoma less
severe than that requiring traditional
incisional surgery
 should preserve the conjunctiva from
surgical dissection.
 Types-
 Bypass TM resistance with stents into SC
- iStent, Hydrus
 Via drainage into the suprachoroidal space
- Cypass, iStent Supra
 By excision of TM itself
- Trabectome
 Endo-cyclodiode - directly observed ablation of
ciliary processes under endoscopic control .

29. iStent® Trabecular Micro-Bypass
Hydrus Microstent
Tri-modal mechanism:
Tail end provides a direct inlet from AC into Schlemm’s
canal
Body of the stent maintains the patency of the canal

30. CYPASS Micro-stent
Withdrawn in August 2018
Detection of a dramatic rise in endothelial cell loss (ECL)
among patients who received the CyPass microstent
during cataract Sx. Trabectome
Micro-electrocautery
handpiece designed to
ablate TM & SC inner wall
tissue.
Descemet’s injury
Ciliary body injury
Reflux bleeding, hyphema

31. ENDO-CYCLODIODE
PHOTOCOAGULATION
Diode laser causes effective
cycloablation while avoiding damage
to adjacent structures.

32. A procedure that
surgically opens Schlemm’s
canal, exposes Descemet’s
memb & bypasses the
highest resistance to
outflow – juxtacanalicular
TM.
To prevent the
inevitable late stage fibrosis
various materials have
been used.
IMPLANTS FOR NON- PENETRATING
DEEP SCLERECTOMY:
Aquaflow (collagen)

33. CLASSIFICATION :
 ABSORBABLE
• Collagen implant
(Aquaflow )
• SKGel implant
(reticulated sodium
hyaluronate)
• Healon GV
 NON- ABSORBABLE
• TFLUX implant
• TBAR implant
• MERMOUD X
• MEHTA HEMA WEDGE
• BIOSPONGE

34. Advantages
 Avoids sudden
hypotony
Complication
 Perforation of
trabeculo-
Descemet’s memb
 Scleral perforation &
choroidal prolapse
Disadvantages
 Difficult technique
 Less effective IOP
control compared to
trabeculectomy

35. INTRA-OCULAR LENS
Intra-ocular lens (IOL ) is an artificial lens that
is implanted inside the eye during cataract or
refractive surgery, to correct the eye’s optical
power.

36. IDEAL IOL
 Non-reactive
 Non-carcinogenic
 Non-biodegradable
 Transparent
 High optical resolution
 UV filtering
 Accommodating for near &
distance
 Should pass through smallest
incisions
 Withstand stress of implantation

37. CLASSIFICATION
Capsular support intact
 PCIOL
No capsular support
 ACIOL
 Iris supported
 Scleral fixated
Phakic IOL
 Post chamber sulcu
fixated
 Angle supported
 Iris supported
Method of fixation

38.  Kelman Multiflex
ACIOL
ACIOL

39. Advantages
 No capsular support
required
 Technically less
traumatic
 Easy to implant
Complications
 Uveitis glaucoma
hyphaema
 Corneal
decompensation, PBK
 CME
 Pupillary block
 Fibrosis of angle
 Iris atrophy & fibrosis
ACIOL

40. IRIS SUPPORTED
 Fixed on iris with sutures,
loops or claws
Singh & Worst
Iris Claw lens
Retropupillary iris claw lens
ARTISAN

41. IRIS SUPPORTED
Advantages
 No capsular support
required
 Cosmetically more
acceptible
 Difficult to diff from
PCIOL
 No ant segment/
angle complication
 Unrestricted
dilatation of iris
 Excellent centration
Complications
 Insufficient iris
enclavation
 Iris chaffing
 Pupillary distortion
 Chronic inflammation
 CME
 Distortion on pupillary
dilatation
 Endothelial
decompensation

42. SFIOL
 This procedure involves
securing the IOL to the
sclera using surgically
created tunnels or sutures.

43. SFIOL
Disadvantages
 Difficult technique
 Longer time of
surgery
Complications
 Suture erosion
 Corneal endoth
damage
 CME
 Endophthalmitis
 Hyphaema/ Vit hem
 Lens tilt/decentration
 RD
 Suprachoroidal hem

45. CLASSIFICATION
IOL optic material
 Non-foldable
PMMA
 Foldable
silicone
acrylic
temperature
dependent polymers
 Rollable
Hydrogel (HEMA)
IOL bio-compatibility
 Uveal
 Capsular
FB reaction is a marker of
IOL biocompatibility.
Hydrophobic acrylic IOL-
max late FBGC reaction
Silicone IOL- min late FBGC
reaction
Hydrophilic acrylic IOL- max
PCO

46. Optic edge
 Round edge- Min glare
Max PCO
 Square edge
 Opti-edge- rounded
anterior
sloping side
sharp vertical posterior
 Enhanced edge-
elevated ridge at O-H
junction
 Textured edge- rough
edge with frosted app
CLASSIFICATION

47. CLASSIFICATION
 Modified J loop IOL
 Modified C loop IOL
 Angling the loops
 IOL with coloured
haptics
 IOL with positioning
holes

48.  One piece IOL
 Three piece IOL
 Disc/ plate lens
CLASSIFICATION

49. ASPHERIC IOL
 Designed to correct +ve spherical aberration of
cornea
 Modified ant prolate surface
 Aspheric post surface – AcrySof
 Aspheric ant & post surface – aberration free
 DISADVANTAGES – IOL decentration cancels
benefits
Degrades near & intermediate BCVA
Asymmetric aberrations cannot be compensated
Surgery can induce SA

50. MULTIFOCAL IOLS
TYPES – Refractive Mf IOL
diff refractive powers in
diff circular zones
Array lens, ReZOOM (5
zones)
Diffractive Mf IOL
diffraction of light
from multiple ring steps on the
post surface of lens which
provides near vision by
constructive interference (30

51. Apodized Mf IOL
Central 3.6mm diffractive &
peripherally refractive structure

52. Advantages
 Better performance at
near vision activities,
social activities, etc.
 Spectacle use is lower
 Increased depth of
focus
Disadvantages
 Halos, flare, flash, glare,
streak
 Decrease in contrast
sensitivity
 Astigmatism causes
reduced visual function
 Smaller pupil size –
worse near VA
 Decentration – worse
distance & intermediate
VA

53.  Optic shift principle  Dual optic principle
ACCOMMODATIVE IOLS
Crystalens (silicone)
Akkommodative 1CU (acrylic)
Synchrony
IOL
Sarfarazi Elliptical

54. TORIC IOL

55. BLUE BLOCKING IOL
Advantages
 Reduces ARMD
 Improves contrast
sensitivity
 Reduces glare
 Reduces cyanopsia
Disadvantages
 Decrease in scotopic
sensitivity
 Interference with sleep-
wake cycle

56. PHAKIC IOL
AC angle fixated IOL
 Kelman Duet
 Presbyopic phakic
IOL
PC phakic IOL
 Visian ICL
 Phakic refractive lens
(PRL)
Iris fixated phakic IOL
 Artisan

57. PHAKIC IOL
Advantages
 Stable
 Potentially reversible
 Preserve
accommodation
 Predictable refractive
results
 No change in shape/
thickness of cornea
Complications
 Post-op
inflammations
 Glaucoma
 Iris atrophy
 IOL decentration/
dislocation
 Endothelial cell loss
 Cataract
 Pupil block
 Pigment dispersion

58. CAPSULAR TENSION RINGS
Endocapsular device was first introduced by
HARA et al and NAGAMOTO et al of Japan in
1991 (Equator ring).
Used for expanding, centering and stabilizing the
capsular bag.
Helps prevent capsular phimosis & resists
capsular shrinkage.

59.  TYPES :
• STANDARD CTR
• MODIFIED CTR OR CIONNI’S RING
• HENDERSON CTR
• CAPSULAR TENSION SEGMENT OR
AHMED CTS
 STANDARD CTR :
TYPES:
MORCHER (REFORM) Ring
OPHTEC (STABILEYES) Ring

60.  MODIFIED CTR OR CIONNI’S RING :
Developed by DR. ROBERT CIONNI in
1998
 HENDERSON CAPSULAR TENSION
RINGS :

61.  CAPSULAR TENSION SEGMENT OR AHMED
CTS
Designed by IKE AHMED IN 2002.
FUNCTIONS OF CTR :
• Expansion of capsular equator
• Buttress areas of weak zonules
• Recruit & redistribute tension
from
existing zonules.
• Re- center a mildly subluxated
capsular bag.
• Place tension on the posterior
capsule to decrease incidence of
PCO.

62. CONTRA-INDICATIONS :
• Complete CCC not attained
• PCR or anterior radial tear
• Extensive generalized zonular
weakness
• M- CTR in pts of scleral disorder.
COMPLICATIONS :
• Pupillary capture
• Secondary glaucoma
• Retinal detachment
• Inadvertent tear of anterior capsule
• Decentration or displacement of IOL

63. DRUG DELIVERY IMPLANTS
Sustained Release drug delivery implants have
been developed for treatment of ocular
diseases.
TYPES : INTRA-OCULAR & EXTRA-OCULAR
ADVANTAGES :
 Achieve prolonged therapeutic concentration
 Limits side-effects of systemic therapy
 Limits frequent dosing
 Better patient compliance
 Cost effective

64. INTRA- VITREAL IMPLANTS:
 RETISERT :
• Disc- shaped non-
biodegradable implant
(3x2x5) mm3
• Contains matrix of
fluocinolone acetonide (0.59
mg) coated with silicone &
poly vinyl alcohol attached
to a 5.5 mm silicone suture
tab.

65.  VITRASERT :
• Ganciclovir sustained release
implant for treatment of CMV
retinitis.
• Tablet of 4.5mg ganciclovir
released over a period of 5-8 m
 ILUVIEN :
• Previously, known as Medidur
• Non-erodable implant in phase
3
clinical trials for extended
delivery of fluocinolone
acetonide in diabetic

66.  OZURDEX :
• Bio-degradable, slow release
implant containing
Dexamethasone 0.7 mg released
over a period of 6 m
• FDA approved for treatment of
macular edema associated with
retinal vein occlusion.
 POSURDEX :
• Polymer pellet that releases
drug
as it degrades
• Completely dissolves in 37

67.  OCUSERT :
• Non- biodegradable
conjunctival
insert for treatment of
glaucoma
• Releases pilocarpine 20/40 upto
7d
EXTRA- OCULAR IMPLANTS :
 LACRISERT :
• Biodegradable, containing
hydroxypropyl cellulose 5mg

68. NEWER IMPLANTS :
• Implantable titanium screw (I- vation)
• Punctal plugs (latanoprost punctal
plug delivery system)
• Encapsulated cell technology
• Scleral implants of ganciclovir
• Scleral implants of ethacrynic acid
• Sub-retinal implants of sacrolimus &
triamcinolone acetonide
• Episcleral implant of cyclosporine
(Lumitect)
• Intra-cameral implant of
dexamethasone.

69. RETINAL IMPLANTS

70. RETINAL IMPLANTS
A retinal implant is a biomedical implant
technology meant to partially restore useful
vision to people who have DOV due to
degenerative conditions eg. RP or macular
degenerations.
TYPES :
 Epiretinal – on retina
 Subretinal – behind retina
 Suprachoroidal – above vascular choroid

71. Epiretinal Implants:
Epiretinal prostheses are
placed on the anterior
surface of the retina, where
they stimulate ganglion
cells.
 ARGUS device
 Learning Retinal Implant
 EPI-RET device

72. ARGUS II DEVICE
(A) Wearable external unit with the camera attached to glasses and the TX coil on
the corner.
(B) Implant RX coil encirculating the eyeball being powered from an external TX coil
using the NRIC scheme in the epiretinal implant (The RX coil is placed on the
side of the eyeball, whereas the electrode array is inserted into the eyeball
through an incision centrally on the retina, adjacent to the optic nerve).
(C)Actual retinal implant device

73. Advantages
 Bypass large portion
of retina & rely on
ganglion cells
function
 Provide visual
perception in retinal
diseases beyond
photoreceptor layer
Disadvantages
 Requires external
apparatus
 External camera
requires a subject to
make head
movements to change
their gaze
 Stimulate nearby
axons – distorted
stimulation pattern
(corrected by
electronic processing)

74. Subretinal Implants:
Subretinal devices are placed
beneath the retinal pigment
epithelium in the photoreceptor
layer
 Optobionics
 Retina Implant Alpha IMS
 Boston Subretinal Implant
project

75. BOSTON SUBRETINAL IMPLANT PROJECT

76. Advantages
 Simpler design
 Placement more
straight forward
 Allow normal inner
retinal processing
 Use normal eye
movements to shift
their gaze
Disadvantages
Lack of sufficient
incident light
Compact subretinal
space imposes size
constraint
Thermal damage to
retina
Require intact inner &
middle retinal layers

77. SUPRACHOROIDAL IMPLANTS:
Suprachoroidal prostheses are designed to be
placed between the choroid and the sclera
 Bionic Vision Australia

78. ORBITAL IMPLANTS

79. ORBITAL IMPLANTS
For patients who underwent
enucleation or evisceration
operation and want a more
natural appearance and
movement that mimic that of
their normal eye.
PURPOSE:
 Replace the volume lost by
the enucleated eye
 Impart motility to prosthesis
 Maintain cosmetic symmetry

80. AN IDEAL IMPLANT :
 Mimics normal globe closely
 Replaces sufficient volume
 Minimal rate of exposure, extrusion,
infection, inflammation
 Non-antigenic, inert
 Socket motility transmitted to prosthesis
 Completely buried
 Light wt., anchored to orbital tissue
 Integrate into EOM & orbital tissues
without adhesions
 Affordable & easily available

81. CLASSIFICATION:
NON- INTEGRATED
SEMI- INTEGRATED
INTEGRATED
BIO- INTEGRATED
BIOGENIC

82. NON- INTEGRATED IMPLANTS
Advantages: Inexpensive
Exposure is rare
Least complication rates
Can attach muscles if
wrapped with
sclera
Disadvantage: poor motility if not
wrapped
Examples: PMMA , Silicone

83. NON- INTEGRATED IMPLANTS
 Attachment of EOM in tunnels on
anterior surface for better motility
 Allens, Iowa, Universal, etc.
 Advantages:
Good motility
Inexpensive
PMMA
 Disadvantages :
Ant. Surface is irregular
Discomfort & high extrusion/ erosion
rates

84. BIO- INTEGRATED IMPLANTS:
 Porous
 Fibrovascular ingrowth of tissues
 Eg. Hydroxyapatite, aluminium oxide,
polyethylene, porous PMMA
H Aluminium Polyethylene

85. Advantage: Allows
fibrovascular
in-growth
Displacement &
extrusion
Motility
Disadvantage:
Expensive

86. IMPLANTS FOR ANOPHTHALMIC SOCKET
These are meant to enhance the growth of the
involved orbit to allow retention of a suitable
prosthesis & to maximize facial symmetry.

87. EXPANDABLE IMPLANTS:
 Expand in vivo
 Stimulate orbital growth
 In congenital clinical anophthalmos/
microphthalmos
 Fill deficits in enophthalmic sockets
 Eg. Silicon balloon expanders, Hydrogel socket,
orbita expanders
 SETE devices (Self Expanding Tissue Expanders)
Absorb body fluids to 8 times of original volume

88. IMPLANTS IN ORBITAL WALL

89. IMPLANTS FOR ORBITAL FLOOR FRACTURE
The most common orbital walls to be
affected by trauma are the floor & the medial
wall.
CLINICAL INDICATIONS FOR REPAIR :
• Diplopia
• Extraocular muscle entrapment
• A large # (greater than 50% of wall )
• Enophthalmos greater than 2mm

90. IMPLANTS USED ARE :
• Alloplastic implant : Porous polyethylene
(Medpor) silastic, teflon, silicone, PMMA,
hydroxyapatite
• Autologous materials : Dermis fat graft
Fascia lata grafts & sclera
• Dissolvable alloplastic material : Gelfilm,
Lactosorb
• Allogenic material : Banked bone or lyophilized
cartilage

92. IMPLANTS FOR LACRIMAL SYSTEM

93. IMPLANTS FOR LACRIMAL SYSTEM
PUNCTAL PLUGS :
Used in patients with
chronic dry eye not adequately
controlled with medications.
Other uses :
 To enhance efficiency of
ocular therapeutics
(glaucoma therapy)
 To prevent drainage of
drugs into nasolacrimal
system in susceptible
patients.

94. TYPES OF PLUGS :
• Absorbable: Made of collagen or
polymers. Occlusion duration ranges from
7- 180 days.
• Non- absorbable: Made of silicone.
Two types available :
punctal & intra-canalicular
• Cylindrical smart plug : Made of
thermo-sensitive,
hydrophobic acrylic
polymer that changes
from rigid solid to soft

96. INTUBATION IN LACRIMAL
SURGERY
Essential in some congenital
& acquired cases especially as a
sequel to trauma.
It is useful to treat epiphora in
selected group of patients esp. in
children & as an alternative to DCR.

97. INTUBATION IN DCR
INDICATIONS :
 Cong dacryocystitis
-failed multiple probings
-child >1y
 Partial NLD obstruction
 Failed DCR
 Post traumatic dacryocystitis
 Canalicular obstruction
 Conjunctival DCR with Jones tube
 Canalicular laceration
Crawford
lacrimal
intubation set
AIM OF STENT : Used to maintain proper
alignment of an anastomoses & to prevent
scarring.

98. CONJUNCTIVO-DCR WITH JONES TUBE
INTUBATION:
 Cases of canalicular obstruction
 Made of
Pyrex glass
Polyethylene
Silicon

99. Canalicular Lacerations: Repair
with the Mini-Monoka®
monocanalicular Intubation
INTUBATION IN CANALICULAR LACERATION
Goal: reanastomose
mucosa of canaliculi so that
anatomical & physiological
functions are restored.

100. TYPES :
• Mono-canalicular stents
Eg. Mini-Monoka, Ritleng stent
• Bi-canalicular stents
MATERIALS :
• Organic : thick hair, catgut,
metal probes, metal rod with 4’o
braided silk etc
• Synthetic: nylon, pyrex-glass,
poly-ethylene, silicone, etc.

101. RECENT ADVANCES IN IMPLANTS
PresVIEW SCLERAL IMPLANT for presbyopia
 4 plastic segments
 Act like spacers, pulling sclera away from lens,
tightening the zonules & allowing them to aid
accommodation

102. Kamra inlay for presbyopia
 3.8 mm disc with 1.6 mm opening in centre
 Placed directly in front of pupil

103. Implantable Miniature Telescope
 End Stage AMD
 Images are 3 times larger

104. Implantable Eye Jewellery
 Platinum alloy

105. CONCLUSION
 The globe is home to the most common implant,
the IOL after cataract surgery. The lid and lacrimal
implants harbor devices that improve
physiological function.
 Orbital fractures are repaired with light metals.
 The anophthalmic sockets, depending on its age,
have been filled with many implants.
 All implants may have complications which
include ocular or orbital infections, migration or
extrusion.
 Implants in ophthalmology are of wide range & in
every sphere, much advancement is going on,
both in terms of material as well as in technique.

106. 108