Primary Intraocular Lens Implantation
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Primary intraocular lens (IOL) implantation is performed when a cataract is removed and an IOL is implanted at the time of cataract surgery. Lensectomy is recommended for any visually significant lens opacity in a child. Patients who are less than 7 months of age are left aphakic in the developed world. However, in developing countries primary IOL implantation is more common in infancy. IOL power selection is dependent on the age of the child at the time of cataract surgery. Implanting a lens that results in residual hyperopia is common practice. When placing an IOL, lenses can be placed in the capsular bag and sulcus or fixated to the fused anterior and posterior capsular remnants. Placement depends on surgical preference and stability of the capsule. A posterior capsulotomy should be created at the time of primary IOL implantation in young children since posterior capsular opacification (PCO) universally occurs without treatment. In older children the posterior capsule can be left intact and an in-office neodymium:YAG capsulotomy of the posterior capsulotomy can be performed at a later date when the posterior capsule begins to opacify.
KeywordsPrimary intraocular lens Aphakia Posterior capsule opacity (PCO) Lens power selection Refractive goal Posterior capsulorhexis Anterior capsulorhexis Optic capture
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