Refractive Lens Surgery

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enhanced visual function that remains stable. Since aberrations in the cornea do not change with age and potential progressive crystalline lens aberrations are eliminated with lensec- Fig. 17.11. Digital light delivery device (DLDD). (Courtesy of Calhoun Vision Inc.) a b Chapter 17 The Light-Adjustable <strong>Lens</strong> 169 tomy, wavefront treatments to the LAL should not change with time and should produce a stable aberration-free optical system throughout the patient’s lifetime. Fig. 17.12. A tetrafoil spatial intensity pattern is represented digitally. This pattern can be directly transferred to a LAL or an inverse pattern could likewise be irradiated to the LAL to correct this aberration. (Courtesy of Calhoun Vision Inc.) Fig. 17.13. a LAL interferometry pattern before and after irradiation with DLDD to create tetrafoil wavefront. b Three-dimensional representation of tetrafoil wavefront created in LAL. (Courtesy of Calhoun Vision Inc.)
170 R.S. Hoffman · I.H. Fine · M. Packer FINAL COMMENTS Cataract surgery has come a long way since the time of intracapsular extraction and large-incision extracapsular surgery. Incremental advancements in phacoemulsification technology have allowed ophthalmologists to offer their patients the safest and most rapidly visually rehabilitative cataract surgery ever available. Emphasis now has shifted to improving IOL technology. Research into newer multifocal and accommodative IOLs will be instrumental in allowing ophthalmologists to provide not only stateof-the-art cataract surgery but also to offer refractive lens exchanges to their refractive surgery patients as a means of treating distance-refractive errors and the presbyopic condition. Current limitations in cataract and refractive lens surgery stem from the inability to guarantee emmetropia in even the most experienced hands. In addition to many other options, the LAL offers an incredible opportunity for ophthalmologists to deliver excellent postoperative visual acuities. IOLs will now have the potential of being finetuned following surgery to provide not only emmetropia but also multifocality and higher-order aberration-free corrections if the patient desires. The early reversible nature of the LAL prior to the final “lock in” will allow patients the opportunity to experience monovision, multifocality, and wavefront-guided treatments and then decide whether that refractive status is acceptable. The LAL is truly one of the great revolutions in modern cataract and lens surgery. Clinical trials in the USA commenced in 2003. References 1. Brandser R, Haaskjold E, Drolsum L (1997) Accuracy of IOL calculation in cataract surgery. Acta Ophthalmol Scand 75:162–165 2. Drexler W, Findl O, Menapace R et al (1998) Partial coherence interferometry: a novel approach to biometry in cataract surgery. Am J Ophthalmol 126:524–534 3. Giers U, Epple C (1990) Comparison of A-scan device accuracy. J Cataract Refract Surg 16: 235–242 4. Watson A, Armstrong R (1999) Contact or immersion technique for axial length measurements? Aust NZ J Ophthalmol 27:49–51 5. Packer M, Fine IH, Hoffman RS et al (2002) Immersion A-scan compared with partial coherence interferometry. Outcomes Analysis. J Cataract Refract Surg 28:239–242 6. Olsen T (1992) Sources of error in intraocular lens power calculation. J Cataract Refract Surg 18:125–129 7. Pierro L, Modorati G, Brancato R (1991) Clinical variability in keratometry, ultrasound biometry measurements, and emmetropic intraocular-lens power calculation. J Cataract Refract Surg 17:91–94 8. Masket S, Tennen DG (1996) Astigmatic stabilization of 3.0 mm temporal clear corneal cataract incisions. J Cataract Refract Surg 22: 1451–1455 9. Schwiegerling JT, Schwartz DM, Sandstedt CA, Jethmalani J (2002) Light-adjustable intraocular lenses. Review of refractive surgery; Newtown Square, Jobson Publishing, LLC, Feb 2002 10. Packer M, Fine IH, Hoffman RS (2002) <strong>Refractive</strong> lens exchange with the Array multifocal lens. J Cataract Refract Surg 28:421–424 11. Rodriguez A, Gutierrez E, Alvira G (1987) Complications of clear lens extraction in axial myopia. Arch Ophthalmol 105:1522–1523 12. Ripandelli G, Billi B, Fedeli R, Stirpe M (1996) Retinal detachment after clear lens extraction in 41 eyes with axial myopia. Retina 16:3–6
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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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10 The Eyeonics Crystalens Steven J
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Fig. 10.3. Under binocular conditio
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Fig. 10.6. Anterior movement of the
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Fig. 10.7. One- and 3-year data fro
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10.6 Postoperative Considerations C
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10. Dell SJ (2004) Objective eviden
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100 N.X. Nguyen · A. Langenbucher
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12 CORE MESSAGES Synchrony IOL H. B
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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
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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
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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
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
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Page 202 and 203: 5. Tsuneoka H, Shiba T, Takahashi Y
Page 204 and 205: 200 J.L. Alio · A. Galal · J.-L.R
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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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