We use more from a 3 piece lens like technis aspheric acrylic or alcon 3 piece spherical lens.
I would prefer `The Tecnis monofocal IOL which gives better clarity during fundiscopy and increased contrast. Tecnis is an aspheric IOL as acrysof, however when I used it I found it superiorly better.
Alcon acrysof should be the choice because of anticipated DR related examinations and interventions anticipated.
In these eyes I routinely implant the bag-in-the-lens which has the advantage to erradicate PCO and allows open view on the posterior segment of the eye. We are participating at the ESCRS premed study on postoperative CME, which is clinically absent in our series and subclinically present in the same order than the classical IOL implantation. This is to be expected since the latter is related tosurgical stress problem.
I think there is no question whether you put Alcon or amo lens,it is
important make a bigger capsulorrhexis & 6 mm optic Iol which will help you to follow up to detect or progression of DR & prevent dev of PCO . It will also help you to do scattered laser photocoagulation, & vitrectomy if required,
There are too many types of IOL you can use.. I would just list those that you should not use.
1. SILICON IOL: As if in future, Vitrectomy with SiO required, there might be interaction between both material.
2. BLUE BLOCKING IOL: In patients with DR, AMD an other retinal problems, Scotopic vision is worse with this kind of IOLs.
3. HYDROPHILIC ACRYLATE: They increase chance of PCO.
4. MULTIFOCAL IOLs: they decrease Contrast sensitivity.
Hydrophobic Acryl IOL, but not Silicon one taken into account the future pars plana vitrectomy with silicon oil endotamponade
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