Crystalens Exchange: Z syndrome repair by Steven G. Safran MD

This is a patient who presented with the sudden onset of decreased vision due to a Z syndrome 5 weeks after her original Crystalens surgery. Her cataract surgeon treated her with Atropine and topical steroids for 2 weeks and then referred her to me for surgical management. I chose to exchange the lens for a Crystalens AO one diopter higher in power and to place a CTR. Her original clear cornea was at one O"clock and was inducing some cornea flattening contributing to her 1.7 diopters of astigmatism so this was revised and a scleral tunnel incision placed on the steep axis to reduce her astigmatism further. This was successful as the patient saw 20/25+2 uncorrected the first day with excellent positioning of her new implant.

Category:

Science & Technology

Tags:

• Crystalens
• Xchange
• Z
• 1

[sgsafran]

This Z developed because the haptics were not positioned properly in the equator of the bag. The combination of haptic malposition and capsular fibrosis led to the Z. The lens could not be repositioned because one haptic was scarred in place. The lens was also the wrong power. The patient wanted Crystalens because she was very happy with the Crystalens she had in her other eye. After this exchange was performed she did extremely well and did not develop another Z syndrome.

[vikeyesurgeon1]

Why you replaced the Crystalens with another Crystalens, even after the patient had experienced Z syndrome complication because of Crystalens implant.