Post-op gel behind IOL
Posted , 3 users are following.
I recently had an IOL exchange at the ~11-12month mark. The first eye went smoothly, but the second eye three weeks later resulted in a considerable myopic outcome.
I saw the surgeon yesterday, three weeks post-surgery on the second eye.
He said the myopic outcome was caused by some gel from the operation remaining in the capsular bag behind the new IOL, pushing it forward.
I left a little confused as to whether this gel left over from the surgery would clear naturally.
I have another appointment in four weeks to "see where my vision settles".
Has anyone here had this issue with gel remaining in the capsular bag post-op, or know the possible prognosis?
0 likes, 8 replies
RonAKA steven64823
Edited
I can't say but significant amounts of "gel" is used during the surgery. I am sure it is designed to be absorbed into the tissue and not remain for any long length of time.
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RonAKA
Edited
So we can't look at a video of an actual lens exchange? This site certainly has a very strange system of moderation when participants cannot get some education by watching a University of Alberta teaching professor doing lens exchange surgery.
steven64823 RonAKA
Edited
Thanks Ron. I eventually found a video showing the use of the viscoelastic gel.
Subsequently, a research paper stating: "All viscoelastics should be completely removed from the eye to reduce the likelihood of increased intraocular pressure. Should OVD retention behind the IOL occur, an unstable refraction could result. Residual high molecular viscous substance is transported away through the trabecular meshwork, with delay, possibly resulting in a protracted postoperative IOP increase."
To my untrained eyes, this would indicate the gel should eventually be absorbed, but may take some time. If this is the case, I'm relieved.
Guest steven64823
Posted
Good find. I would add that if your IOP is high there are eye drops for that. When is your next followuup?
steven64823 Guest
Posted
My next appointment is 30 Oct. I had my eye pressures checked at the recent appointment and both eyes were normal. A reading of 11 in each, from memory.
Guest steven64823
Edited
To be clear on the timing (because I found it a little confusing) you had surgery a year ago on both eyes and then three weeks ago you had both of them exchanged… with a three week space between the two exchanges? Is that right? I've never heard of viscoelastic gel being left behind but hopefully it resolves. Let us know how it goes.
steven64823 Guest
Posted
Hi David.
Yes, you have it right - I had the two Vivity lenses exchanged for two Rayner EMV lenses three weeks apart. Cataract surgery in Sept(L)/Oct(R) '22 with the Vivity, IOL replacement in Sept/Oct '23 with the Rayner EMV.
I trust Ron is correct and the viscoelastic gel is absorbed. It's a disappointing result at this stage, as the first eye, set at ~plano, is fantastic. I'm very happy with the depth of field and quality of vision. A big improvement for me. Apparently the second eye was targeted at -0.25 for a tad more intermediate vision, which probably would have been ideal had we landed there.
I was told the second surgery was more involved than the first, hence needed lots of gel. There were a considerable issue overcoming adhesions, whereas the first eye lense "just slipped straight out". Shows the risks of waiting so long before the IOL exchange, I guess.
Thanks for the responses, Ron and David.
steven64823
Edited
That ^ should read IOL replacement at Aug(L) '23 and Sept (R) '23. so a bit over 11 months between the initial lenses and their replacements.