Refractive Lens Surgery

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134 F.M. Sarfarazi Fig. 13.18. Working of haptics after carbachol (1) Fig. 13.19. Working of haptics after carbachol (2) Fig. 13.20. Working of haptics after carbachol (3) Follow-up testing at 4 and 7 weeks after IOL insertion showed that the separation between the two optics decreased by about 20% after carbachol. However, no decrease in accommodation occurred over time because the lens adapted to the size of the capsular bag. Repeated tests indicated that the monkey eye consistently achieved 7–8 diopters of accommodation (Fig. 13.22). Two of the monkeys exhibited significant inflammation. However, the prototype lenses were not made under processes normally used for human lenses. Recent electron microscope examinations of the prototype lenses indicate that the polymer contained significant contamination. It is believed that this contamination was the major contributor to the inflammation. This is not expected to be a concern for the lenses being developed for human implantation, which will utilize manufacturing processes currently developed for human IOLs.
Fig. 13.21. Anterior chamber depth as measured by Scheimpflug imaging (Carb carbachol) Fig. 13.22. Accommodation measured using refractometer FINAL COMMENTS Chapter 13 Sarfarazi Elliptical Accommodative 135 The ability of the Sarfarazi EAIOL to accommodate appears to be primarily due to the shallowing of the anterior chamber and lens thickening as observed in UBM imaging. These tests indicate that this EAIOL can emulate the performance of the natural lens and can potentially achieve a significant degree of accommodation. The implantation procedures are simple and effective and do not require any unusual equipment or techniques. Observation of the monkey eyes after implantation demonstrated that the use of this lens in place of conventional IOLs is safe and has no adverse reaction on the eye structures involved. No atrophy or changes in the ciliary muscle structure were observed several months after the EAIOL was implanted. Enrolment of patients for clinical feasibility studies has now been initiated. Acknowledgments. The funding for this project was provided by the National Eye Institute. Shenasa Medical, LLC wishes to thank the National Eye Institute for their ongoing and generous support. I would like to express my sincere thanks to Dr. Nick Mamalis, Dr. Paul Kaufman, Dr. Adrian Glasser, Dr. Greg Healy, Maryann Kraft, Jared McDonald, Doug Malcolm, Gene Kyberz, Daniel Riley, Josh Enin, Michael Wilson, Leonard Solomon and Merle Symes who made various contributions and for their continuous support of this project.
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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
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Fig. 8.2. AcrySof toric IOL implant
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Fig. 8.3. Mean absolute residual cy
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References 1. Hoffer KJ (1980) Biom
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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 136 and 137: 128 F.M. Sarfarazi Fig. 13.5. Mecha
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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
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Page 164 and 165: 16.7 Blue-Light-Filtering IOLs and
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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
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Page 182 and 183: 176 S. Norrby Fig. 18.3. Scheimpflu
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Page 190 and 191: 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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