Case Studies
Interesting cases shared by Sonomed Escalon Hub members highlighting their experiences with UBM AI + ICL Guru, including challenging patients, unusual circumstances, sometimes surprising results, and wisdom gained. Please reach out if you are interested in sharing your experiences with other ICL surgeons.
Replacement of Visian ICL With EVO ICL
Eva Kim MD | ICON Eyecare (Denver, USA)
Background
A 33-year-old man came to my practice having spherical ICLs implanted 12 years ago.
He had no sign of cataracts after examination; his refraction was -2.00 in both eyes. Also, he had additional LASIK for residual myopia and astigmatism just after first ICL surgery. The vault was about 30 µm in both eyes. It’s good to know that he went 12 years without any specific problems with the Visian ICL. It was not possible to obtain any records or information about the previous surgeries. The patient wanted the Visian ICL to be explanted and new EVO ICLs to be implanted.
Approach
I proposed to remove the ICLs and wait for 5 weeks to verify that the refraction remained stable. After that period, the refraction indeed remained stable and I decided to proceed to size the ICL’s to be implanted using UBM AI + ICL Guru.
ICL Sizing
UBM imaging was obtained on both eyes using the Sonomed Escalon UBM AI and images were uploaded to ICL Guru for calculation. The ICL Guru report did not show a green band of vault based on the anatomy of the patient, including relatively shallow ACDs. After consultation with other UBM AI + ICL Guru users, I selected 13.2 mm for the right eye and 12.6 mm for the left eye, since both of these sizes were solidly within the blue range.
Results
The post op results show a good vault in both eyes (196 µm OD and 105 µm OS) in reasonable agreement with the predicted vaults. Refraction at 1-week, 3-weeks, and 5-weeks post-implantation is stable at 20/25 OU. The patient has no evidence of glaucoma or anterior chamber angle compromised whatsoever. UBM AI + ICL Guru. provided me with confidence to proceed with this procedure and the correct lens sizes were definitely implanted.
