Advanced Anterior Segment Surgery
The anterior segment is the front part of the eye, including the cornea, iris and lens. Some problems in this area require a more individualized approach than routine cataract surgery.
Previous surgery, glaucoma, trauma, weak lens support, absence of the natural lens (aphakia), iris abnormalities or a displaced intraocular lens (IOL) can alter the anatomy of the eye and change the balance between the available surgical options.
Dr Seif’s advanced anterior segment practice focuses on complex lens, IOL and iris problems, particularly in previously operated eyes and in situations where glaucoma must be considered as part of the same plan.
Complex lens and IOL surgery
Management may include complex cataract surgery, unstable or dislocated lenses and IOLs, aphakia, IOL repositioning or exchange, and secondary lens fixation when normal capsular support is inadequate.
The appropriate strategy depends on the remaining capsule and zonules, cornea, iris, retina, glaucoma status, previous surgery and the desired refractive result.
The operation is selected for the anatomy of the eye rather than by applying one fixation method to every case.
Iris repair and pupilloplasty
The iris is the colored part of the eye surrounding the pupil. Iris defects after injury or surgery, irregular pupils and abnormal pupil size can contribute to glare, light sensitivity and optical distortion.
In selected cases, iris repair, pupilloplasty or reconstruction can improve the function and shape of the pupil and may be combined with lens surgery when appropriate.
When glaucoma changes the anterior segment plan
Complex lens or iris surgery becomes more demanding when glaucoma is also present.
Planning must account for current pressure control, previous glaucoma procedures, angle anatomy and future glaucoma options. In some eyes, anterior-segment reconstruction can be combined with pressure-lowering surgery. In others, staging the procedures is preferable.
Previously operated eyes and second opinions
An eye that has already undergone cataract, glaucoma, corneal or trauma surgery may have several interacting problems rather than a single diagnosis.
A focused consultation aims to identify the main cause of the current problem, understand the available support and anatomy, and establish a logical surgical sequence before another operation is undertaken.