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Michael J Ang, Poorav Patel, Judy J Chen, Arthur D Fu; Outcomes of 25 or 27 Ga PPV and Akreos AO60 secondary lens implantation performed by trainees with supervision. Invest. Ophthalmol. Vis. Sci. 2018;59(9):850.
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To determine visual outcomes and complications of Akreos AO60 secondary lens implantation performed at a teaching institution by senior residents and/or fellows.
Retrospective, interventional case series. Outcomes measured were change in visual acuity and occurrence of intraoperative or postoperative complications, such as vitreous hemorrhage, cystoid macular edema, ocular hypertension, corneal edema, hypotony, endophthalmitis, and suture breakage or erosion. A Bausch & Lomb Akreos AO60 lens was implanted in all eyes and sutured in place with Goretex suture. A chart review was performed on patients identified from surgical operative reports for current procedural terminology codes 66985 (insertion of IOL prosthesis, not associated with concurrent cataract removal), 66986 (exchange of IOL), and 66825 (repositioning of an IOL prosthesis). All cases were supervised by an experienced vitreoretinal attending surgeon.
11 eyes of 11 patients were identified (6 males, 5 females). Four eyes required secondary lens implantation due to retained lens fragments, 5 eyes for dislocated PCIOLs, 1 eye for malpositioned PCIOL in the AC, and 1 eye for Uveitis-Glaucoma-Hyphema syndrome. Mean age at surgery was 63.8 years old (median 65.5 years, range 48.1 years to 75.5 years). Best mean VA improved from 0.944 logMAR units (20/175) to 0.415 logMAR units (20/52). Mean follow up time was 129.5 days (median 56 days, range 25-498 days). An incidental retinal break was found and treated in one eye during surgery. Post-operative complications included transient corneal edema in 7 eyes (63.6%), hypotony in one eye (9.1%), ocular hypertension in one eye (9.1%), and CME in one eye (9.1%). There were no cases of endophthalmitis or suture breakage.
25 or 27 Ga PPV and Akreos AO60 secondary lens implantation was well tolerated, though transient corneal edema appeared to be the most common post-operative complication. The incidence of postoperative complications was similar to those reported in previous studies. Therefore, we conclude that secondary lens implantation of an Akreos AO60 lens can be safely and effectively performed by trainees with appropriate supervision.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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