IOL Information

Dr. Hagan:
Needed to know if the one piece IOLs such as Toric & Tecnis have more stability than the two wire
haptic IOLs.  Also, is the 4 haptic Bausch & Lomb Akreos series even more stable in terms of how
it secures itself into the capsular bag.
May I have the name of the med used to dialate the pupils for eye exams? Is there a more natural,
less caustic preparation - maybe even herbal based?
Thank you for your candid replies.
Laura5121

[John C Hagan III, MD, FACS, FAAO]

"Wire" (metal) is not used in any moder IOL. The "legs" of an IOL are called haptics. I don't think it makes much differnce whether its a one piece or three piece (one optic and two haptics).

The drops used to dilate the eye are: cyclopentolate, tropicamide, neosynephrine, rarely atropine or homeatropine.

No there are no herbals that will work.

I have no experience with the B&L Akreos.  Capsular fixation is not a problem with moder IOLs except in the most unusual circumstance.

JCH MD

[Liz1887]

What IS capsular fixation?
I've heard so many creepy things about IOLs that shifted or moved.  Is this something that makes them move?
thanks,
L.  

[John C Hagan III, MD, FACS, FAAO]

The IOL is put in the bag (capsule) that the cataract was in. It holds the IOL in place, over time adhesions form and keep the IOL in place and from rotating. Its a good thing

JCHMD

[Liz1887]

Oh.  So the problem that used to occur was that there *wouldn't* be capsular fixation, and so the IOLs would (sometimes) move or shift.   I get it.

Which IOLs did this used to happen with?  What was changed so they don't do this now?

thanks,
L.

[Liz1887]

I ask because I read a rather disturbing post in another group.  They wrote,
"A sudden change [the person's vision became more myopic] has been attributed to the forward motion of an IOL when the anterior capsulotomy latches down to the lens optic and fluid builds up behind it."

So I wonder whether this problem ever still occurs, and which lenses are or were prone to it (were, I hope!!).

thanks,
L.

[John C Hagan III, MD, FACS, FAAO]

It is a rare problem and is not associated with any model of IOL especially. Such a movement when it occurs usually only creates problems for multifocal IOLs
JCH MD