presbyopic lens exchange (prelex) and multifocal iol implantation dr suresh k pandey suvi eye...

Presbyopic Lens Exchange (PRELEX) & Multifocal IOL Implantation

Dr. Suresh K PandeyDr. Vidushi Sharma

SuVi Eye Institute & Research CentreKota, India www.suvieye.comE-mail:suvieye@gmail.comPhome _+91 9351412449

Removal of the crystalline lens and replacement with a pseudophakic lens for the purposes of reducing or eliminating refractive errors

Dr. Suresh K Pandeywww.suvieye.com

Recent Terms- Presbyopic lens exchange (PRELEX) Refractive lens exchange

Older Terms- Clear lensectomy Clear lens phacoemulsification Clear lens extraction Clear lens replacement Clear lens exchange

PRELEX: Peals for Success

Patient SelectionBiometry (K Reading/IOL

Master)/OCTLens Power Calculation Meticulous SurgeryManaging Preoperative Astigmatism

Dr. Suresh K Pandeywww.suvieye.com

PRELEX: IOL Calculations

Holladay 2 formula is the most accurate

–Takes into account disparities in anterior segment and axial lengths by adding white-to-white corneal diameter and lens thickness into the formula

Dr. Suresh K Pandeywww.suvieye.com

PRELEX: IOL Calculations

SRK T formula is compared with the Holladay 2 as a final check

Hoffer Q formula is used for comparison in eyes < 22mm in length

Dr. Suresh K Pandeywww.suvieye.com

PRELREX: Patient Selection

Motivated refractive surgery patients – Avoid the fussy obsessive introspective

Patient Healthy cornea, and tear film Presbyopic, hyperopes are great candidates Avoid low myopes (in beginning) Be conservative with patients whose occupations involve frequent night driving

Dr. Suresh K Pandeywww.suvieye.com

Preoperative Measurements

Thorough Ocular ExaminationPost. Segment- including OCTBIOMETRY

Zeiss IOLMaster™/Lenstar (LS 900)

– Non-contact optical measurements– Partial coherence interferometry to measure axial length– Also measures corneal curvature and anterior chamber depth

Dr. Suresh K Pandeywww.suvieye.com

Presbyopic Lens Exchange (Videos)

Dr. Suresh K Pandeywww.suvieye.com

Piggyback IOL Implantation of Toric and Multifocal IOL (Videos)

Dr. Suresh K Pandeywww.suvieye.com

PRELEX: Refractive Refinement

LASIK

Piggyback IOL

Dr. Suresh K Pandeywww.suvieye.com

Conclusion

Refractive lens exchange constitutes a safe and effective refractive surgical modalityOffers substantial benefits in high hyperopes, presbyopes, and patients with borderline or soon to be clinically significant cataracts who are requesting refractive surgery

Dr. Suresh K Pandeywww.suvieye.com

Presbyopic Lens Exchange (PRELEX) & Multifocal IOL Implantation

Dr. Suresh K PandeyDr. Vidushi Sharma

SuVi Eye Institute & Research CentreKota, India www.suvieye.comE-mail:suvieye@gmail.comPhome _+91 9351412449

Further Reading

Dr. Suresh K Pandeywww.suvieye.com