Fine Tuning of Light-Adjustable IOLs: Capsular Shields Protecting the Retina During Radiation Exposure

Friday, April 17, 2015
KIOSKS (San Diego Convention Center)
Volker Rasch, MD

Purpose
After implantation of Light Adjustable Lenses (LAL) exposure to UV radiation is necessary for the fine tuning of the refractive power of the intraocular lens. To avoid undesired dysphotopsia after the required UV radiation of implanted LAL additionally to the IOL, a capsular tension ring (CTR) wit iris segments was implanted in the same procedure. This reduced the amount of UV light at the retina when fine tuning the LAL.

Methods
Case report of one patient implanted with LALs: first eye without, second eye with additional CTR with iris replacing segments.

Results
After UV radiation of LAL most of the patients complain about photopsia / colourful visual sensations lasting for one day or even longer. What kind of retinal damage or disorder is created by UV radiation of LAL is not understood so far. As UV radiation is necessary with this product we wanted to reduce the amount of UV light transmitted to the retina as much as possible. As the patient complained heavily about visual disturbances after implanting LAL in the first eye, we used a conventional CTR with iris replacing segments to protect the peripheral retina in the second eye. There were no complaints by the patient in this case.

Conclusion
According to our experience when implanting LAL the additional use of CTRs with iris segments will lead to reduced stray light which interferes with the retina and will thus avoid undesired visual sentations. We are now cooperating with an ophthalmic medical device manufacturer to design a special intracapsular protection shield to be used when implanting LAL.