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LZ Kleiman, IP Glavas, JJ Stein, LM Jacobson; Post-operative Results With Implantation of the Acrysof SA-60 Intraocular Lens into the Ciliary Sulcus . Invest. Ophthalmol. Vis. Sci. 2002;43(13):380.
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© ARVO (1962-2015); The Authors (2016-present)
Background: A posterior chamber lens is commonly placed in the capsular bag during cataract surgery. The lens may be inserted into the ciliary sulcus when the capsular integrity is compromised. Alcon's one-piece acrylic foldable lens, the Acrysof SA-60, is FDA approved only for placement in the capsular bag. At our institution, the Acrysof lens was placed in the ciliary sulcus of six patients by two different surgeons. Purpose: The purpose of this paper is to evaluate the postoperative outcome of six patients in which the SA-60 lens was placed in the ciliary sulcus. Methods: The cases of 6 patients who had the lens placed in the sulcus were reviewed for the following: pre and postoperative visual acuity, difference in targeted and achieved post-operative refraction, intraocular pressure (iop), inflammation, centration, iris transillumination defects and cystoid macular edema. Results: Average preoperative visual acuity was 20/100; average postoperative visual acuity was 20/25 with a visual gain of 5 lines on the Snellen Eye Chart. The mean refractive goal was -0.45 diopters and the mean refractive manifest was -0.8 diopters. We found a 0.35 diopter myopic shift that was statistically significant (p value< 0.05) performed with a paired samples t test. The mean postoperative iop was 14.0 +/- 4.5 mmHg. Two out of the 6 patients had low-grade residual postoperative inflammation. All 6 intraocular lenses were well centered. There have been no complications thus far of transillumination defects or cystoid macular edema. The longest follow up is 6 months and the shortest 2 weeks with an average of 3.4 months. Conclusion: Comparison of the postoperative course after Acrysof SA-60 intraocular lens placement into the ciliary sulcus showed no clinically significant differences in visual acuity, intraocular pressure, positioning, transillumination defects and cystoid macular edema. There was a statistically significant myopic shift with placement of the lens in the sulcus, and 2 out of 6 patients had a residual postoperative inflammation. The placement of the Acrysof SA-60 intraocular lens into the ciliary sulcus, while not FDA approved, seems to be well tolerated.
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