Originally Posted by
npdr
First, has the operation already occurred?
Second, if it has occurred, is the question then whether to do a secondary implant vs spectacles or contact lens.
1. Supposing situation 1 - no one plans to do an ICCE / aphakia. It might occur serendipitously because of a complication while a ECCE is being planned such as a more than rigid nucleus or an accidental displacement of the lens. I don't think any surgeon plans for an ICCE even if the patient is -19 to -25.
2. If situation 2 occurs, doing a secondary implant has many quesionable benefits but I have seen very successful ones but many more with poor outcomes. a) corneal decompensation and persistent bullous b) essential iris atrophy c) persistent uveitis d) second time around risk for endophthalmitis. In the hands of a good surgeon, though, I would not wing it. This is an elective procedure and should always entail lenghtly discussion and consent between secondary implant and just aphakia.
Hope this helps.
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