Refractive Lens Surgery

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128 F.M. Sarfarazi Fig. 13.5. Mechanical design Fig. 13.6. Optical design: left unaccommodated; right accommodated pheric surfaces, (c) pupil size, (d) lens placement and dimensions, (e) field of view and (f) wave length. Results were provided on image performance as a function of field position, and there was no difference between these two images. The letter E was clear during the entire accommodation process. 13.6 Prototype Development Initially, several prototypes from different materials such as PMMA, polypropylene, polyimide acetyl (used in heart valves) and Flexeon materials were made using different techniques such as etching and assembling. The PMMA lenses were used with varying haptic materials and configurations. Although the tests of these designs for mechan-
ical and optical properties were satisfactory, insertion in the eye through a 3-mm corneal incision was difficult and caused permanent deformation and/or shear cracks in the haptics. Implantation of two versions of this unit in human cadaver eyes, using an open sky technique, showed that the EAIOL fitted in the capsular bag and occupied the entire bag space. A Miyake technique examination showed that it centered well. Pushing on the anterior lens transferred the force to the posterior lens and the haptics responded to the pressure. These initial tests indicated that a PMMA version of the EAIOL would not be suitable for small-incision surgery and that a more flexible material was desirable. As a result, the development effort shifted to developing complete EAIOL designs from silicone and acrylic materials, both of which are already approved for use in human implantation. In both cases, the model analyses indicated that the finished EAIOL units would be more pliable and therefore more suitable for small-incision insertion. This was especially critical for implantation in the smaller eye of a monkey, which was to be the next phase of testing. 13.7 Primate Testing The goal of the next phase of the program was to design a lens that could be implanted in the eye of a monkey. This work was time consuming and costly due to a lack of information regarding the exact parameters of a monkey eye. Measurements of monkey vision were performed in vivo and in vitro to characterize a monkey’s vision and the lens requirements needed for the study. There had previously been no reported research on such parameters at the depth needed for molding and designing the lens. Further, there was no lens available on the market to fit the monkey capsular bag. Previous studies had been focused primarily on the ciliary muscle structure and the nature of accommodation. Chapter 13 Sarfarazi Elliptical Accommodative 129 Fig. 13.7. Flexible, foldable lens prototype Fig. 13.8. First phase testing: Miyake technique (Dr. Mamalis, University of Utah) Once a flexible,foldable lens prototype was developed (Fig. 13.7), the following tests were conducted. Initial testing of the EAIOL was performed using the Miyake technique in a human cadaver eye. The test indicated that the lens centered well and gave an initial indication that the lens design would function successfully in a monkey eye (Fig. 13.8). A second phase of testing was further proof of concept work on a monkey eye. Using Dr. Glasser’s stretching device to simulate
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Refractive Lens Surgery I. H. Fine
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Editors I. Howard Fine, MD Mark Pac
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Preface The first recorded time a h
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X Contents Chapter 14 AcrySof ReSTO
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Contributors Jorge L. Alio, MD, PhD
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1 The Crystalline Lens as a Target
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2 CORE MESSAGES Refractive Lens Exc
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na that have been observed with som
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piration through two separate incis
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6 R.S. Hoffman · I.H. Fine · M. P
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8 R.S. Hoffman · I.H. Fine · M. P
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10 R.S. Hoffman · I.H. Fine · M.
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12 M. Packer · I.H. Fine · R.S. H
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22 J.T. Holladay 4.1 Introduction T
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24 J.T. Holladay but only seven pre
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26 J.T. Holladay from morning to ni
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28 J.T. Holladay 4.3.2.2.3 Corneal
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30 J.T. Holladay rienced this condi
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32 J.T. Holladay many of these pati
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34 J.T. Holladay IOL eRx V 1336 =
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36 J.T. Holladay raised. A more tho
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38 J.T. Holladay rior segment laser
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40 D.D. Koch · L.Wang corneal refr
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42 D.D. Koch · L.Wang Table 5.1. M
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44 D.D. Koch · L.Wang Fig. 5.4. Nu
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46 D.D. Koch · L.Wang Fig. 5.5. Ce
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48 D.D. Koch · L.Wang ∑ Double-K
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50 L.D. Nichamin surgeon the abilit
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52 L.D. Nichamin Table 6.1. The Nic
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54 L.D. Nichamin 3.2 mm, its neglig
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56 L.D. Nichamin Fig. 6.4. The Nich
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58 L.D. Nichamin References 1. Anon
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60 S. Bylsma aphakic state. In cont
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62 S. Bylsma length),underwent full
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64 S. Bylsma K-Astigmatism
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66 S. Bylsma STIOL in the reversed
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68 S. Bylsma about the dynamics at
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8 Correction of Keratometric Astigm
Page 86 and 87: Fig. 8.2. AcrySof toric IOL implant
Page 88 and 89: Fig. 8.3. Mean absolute residual cy
Page 90 and 91: References 1. Hoffer KJ (1980) Biom
Page 92 and 93: 80 M. Packer · I.H. Fine · R.S. H
Page 98 and 99: 10 The Eyeonics Crystalens Steven J
Page 100 and 101: Fig. 10.3. Under binocular conditio
Page 102 and 103: Fig. 10.6. Anterior movement of the
Page 104 and 105: Fig. 10.7. One- and 3-year data fro
Page 106 and 107: 10.6 Postoperative Considerations C
Page 108 and 109: 10. Dell SJ (2004) Objective eviden
Page 110 and 111: 100 N.X. Nguyen · A. Langenbucher
Page 122 and 123: 12 CORE MESSAGES Synchrony IOL H. B
Page 124 and 125: Fig. 12.1. The single-piece silicon
Page 126 and 127: 12.5 Clinical Results Clinical tria
Page 128 and 129: Fig. 12.6. Retroillumination photog
Page 130 and 131: References 1. Fisher RF (1973) Pres
Page 132 and 133: 124 F.M. Sarfarazi 13.1 The Nature
Page 134 and 135: 126 F.M. Sarfarazi Fig. 13.4. Lens
Page 138 and 139: 130 F.M. Sarfarazi Fig. 13.9. Secon
Page 140 and 141: 132 F.M. Sarfarazi Fig. 13.14. Sche
Page 142 and 143: 134 F.M. Sarfarazi Fig. 13.18. Work
Page 144 and 145: 136 F.M. Sarfarazi References 1. Ma
Page 146 and 147: 138 A. Mirshahi · E.Terzi · T. Ko
Page 152 and 153: 15 The Tecnis Multifocal IOL Mark P
Page 154 and 155: Fig. 15.1. The Alcon AcrySof multif
Page 156 and 157: Fig. 15.4. Multifocal vs. monofocal
Page 158 and 159: 16 Blue-Light-Filtering Intraocular
Page 160 and 161: Fig. 16.2. Cultured human RPE cells
Page 162 and 163: tion to benefiting from less exposu
Page 164 and 165: 16.7 Blue-Light-Filtering IOLs and
Page 166 and 167: 15. Marshall J, Mellerio J, Palmer
Page 168 and 169: 17 CORE MESSAGES The Light-Adjustab
Page 170 and 171: Fig. 17.2 a-c. Cross-sectional sche
Page 172 and 173: 17.4 Animal Studies Dr. Nick Mamali
Page 174 and 175: Fig. 17.8. A laser interferogram (l
Page 176 and 177: enhanced visual function that remai
Page 178 and 179: 13. Mather R, Karenchak LM, Romanow
Page 180 and 181: 174 S. Norrby Fig. 18.1. Small cale
Page 182 and 183: 176 S. Norrby Fig. 18.3. Scheimpflu
Page 184 and 185: 178 S. Norrby Fig. 18.4. Schematic
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180 S. Norrby there was fibrin form
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182 S. Norrby material had a Young
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184 S. Norrby Koopmans et al. [28]
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186 S. Norrby 40. De Groot JH, Zuru
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188 L. Nordan · M. Morris regular
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190 L. Nordan · M. Morris produce
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20 CORE MESSAGES Bimanual Ultrasoun
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for an irrigating manipulator or ch
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5. Tsuneoka H, Shiba T, Takahashi Y
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200 J.L. Alio · A. Galal · J.-L.R
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22 CORE MESSAGES The Infiniti Visio
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Fig. 22.3. The AquaLase handpiece u
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23 CORE MESSAGES The Millennium Ros
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Fig. 23.1. Bausch & Lomb’s new cu
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Fig. 23.2. Advanced flow system car
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Fig. 23.5. Pulse or burst mode with
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24 CORE MESSAGES The Staar Sonic Wa
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Fig. 24.2. The tip undergoes compre
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the sonic tip moves back and forth
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25 CORE MESSAGES AMO Sovereign with
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Fig. 25.3. Schematic diagram of cav
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the Sovereign Compact (see Fig. 25.
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234 M. Packer · R.S. Hoffman · I.
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27 Conclusion: The Future of Refrac
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240 Subject Index Contrast sensitiv
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242 Subject Index P Pachymetry 53,
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