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IOL Selection for Eyes With Unique Anatomy


Nicole Fram, MD concludes this series on the potential of decentration and subsequent IOLs misalignment, highlighting zero and negative spherical aberration lens options for these unique cases.


Nicole Fram, MD discusses the significance of optical center and pupillary center misalignment in certain patients, emphasizing the importance of selecting intraocular lenses (IOLs) with flexibility in de-centration. In cases where the optical center does not align with the pupillary center, Fram recommends IOLs with zero spherical aberration, such as the enVista or the LI61AO. Additionally, lenses like the CT Lucia 621, with a small amount of negative spherical aberration, are noted for their tolerance to de-centration.

Fram specifically considers patients with conditions like zonulopathy, pseudo-exfoliation, abnormal corneas, or de-centered obliques post-LASIK or radial keratotomy (RK). The choice of IOL is tailored to mitigate the impact of de-centration, acknowledging the importance of spherical aberration in these cases. Highlighting recent advancements, Fram speaks of the CT Lucia 621 as an exciting addition to the market. This unique design with an index of refraction of 1.49, minimizing hyperreflectivity on the surface and ensuring it is glistening-free. The CT Lucia 621 is particularly beneficial for eyes susceptible to zonulopathy or de-centration.

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