Cataract and Lens Surgery

Description

This book summarizes the current knowledge on lens surgery. Not only are the surgical procedures described in detail, but experts share with the reader many useful practical tips for individual surgical steps to achieve the best possible surgical result. In addition to the focus on surgery, pre- and post-operative care and complication management is also discussed in detail and a systematic review of the current literature is provided. Clear and concisely written chapters highlight topics such as the use of special lenses, femto-laser lens surgery, secondary lens implantation and phakic lens surgery throughout the book. Cataract and Lens Surgery offers a practical resource for ophthalmologists who perform lens surgery in their daily clinical practice. Clinicians navigating the different types of lens preparations and properties for routine to complex procedures will find this book to be an essential guide. Contents Introduction 1 Implantation of Artificial Intraocular Lenses—A Brief History Bibliography 2 Epidemiology References 3 Anatomy and Physiology of the Anterior Segment Cornea Aqueous Humor Outflow Iris Ciliary Body Lens Lens Transparency and Accommodation References 4 Cataract Forms and Grading Cataract Types Grading of Cataracts References 5 Optical Principles Radiation Optics or Geometrical Optics (GO) Refraction Refractive Power D Aberration Wave Optics Diffraction and Interference Zernike Polynomials Lens Design Bibliography 6 Digitalization in Lens Surgery Introduction Digital Working Environment Example of a Digital Workflow Setting in a University Eye Clinic Setting Digital Toric Lens Surgery: From Planning to Surgery Outlook: Artificial Intelligence References Examination 7 Medical History The Start of the Conversation Ask About Relevant General Medical Conditions Ophthalmologic History Refraction/Glasses/Contact Lens References 8 Testing of Visual Function: Visual Acuity, Refraction, Contrast Sensitivity The Visual Acuity Standards of Distance Visual Acuity Determination Standards of Near Visual Acuity Determination Objective Refraction Determination—Subjective Refraction Determination Objective Refraction Subjective Refraction Postoperative Visual Acuity Prognosis in Dense Media Opacities Measurement of Retinal Visual Acuity by Laser Interference/Retinometer Estimation of Retinal Visual Acuity with the Purkinje Choroidal/Retinal Vessel Shadow Figure Neuronal Functional Testing of the Retina Contrast Vision Objective Measurement of Quality of Vision References  9 Assessment of Optical Phenomena References 10 Slit Lamp Examination References 11 Binocular Vision and Motility Conclusion References 12 Measurement of Intraocular Pressure References 13 Eyelids References 14 Optical Biometry References 15 Scheimpflug Tomography and Measurement of Higher Order Aberrations Scheimpflug Tomography Measurement of Higher Order Aberrations References 16 OCT of the Anterior Segment References 17 OCT of the Posterior Segment References 18 Measurement of Endothelial Cells References 19 Tear Film Analysis References 20 Pupillometry Conclusion References 21 Congenital and Childhood Cataract Examination and Indication for Newborns and Children References 22 Anaesthesia for Cataract Surgery Conclusion References Choosing the Right Lens 23 Design and Material of Intraocular Lenses Design of Intraocular lenses Material of Intraocular lenses References 24 General Introduction to IOL Calculation References 25 Formula Optimisation and Use of the IOL WEB Platform IOLCon 26 Surgically Induced Corneal Astigmatism References 27 Lens Calculation in Short and Long Eyes References 28 IOL Calculation for Particularly Dense Lenses References 29 Intraocular Lens Calculation: Toric and Multifocal Intraocular Lenses Introduction Posterior Surface of the Cornea Formulae for Toric IOLs References 30 Multifocal Intraocular Lens Conclusion References 31 IOL Power Calculation for Secondary IOL Implantation Sulcus-Fixated IOLs Iris-Fixated IOLs Scleral-Fixated IOLs References 32 IOL Power Calculation After Refractive Surgery References 33 IOL Calculation in Patients with Fuchs’ Endothelial Dystrophy References 34 IOL Calculation in Patients with Keratectasia References 35 Planning Lens Calculation in Pediatric Cataract References 36 IOL Calculation in Patients with Retinal Diseases References 37 Aspheric Intraocular Lens: Indications References 38 Indications for Toric Intraocular Lenses Background Astigmatism Correction Indications for Toric Multifocal Intraocular Lenses Indications for Limbal Relaxing Incisions Treatment Options of Irregular Astigmatism Measurement of Corneal Astigmatism Conclusion References 39 Indications for Multifocal and Extended Depth of Focus Intraocular Lenses Introduction References 40 Supplementary Intraocular Lenses Introduction Implantation Indications Conclusion References 41 Considerations in Surgery of Eyes with Cataract and Vitreo-Retinal Diseases Sequential or Combined Cataract and Vitreous Surgery Patients with Cataract and Epiretinal Membrane (ERM) Patients with Cataract and Age-Related Macular Degeneration Patients with Cataract and Diabetic Retinopathy Multifocal IOL in Vitreo-Retinal Diseases References 42 Considerations in the Amblyopic Patient When Planning Cataract Surgery Which Intraocular Lens to Use? References 43 Cataract Surgery—Considerations When Planning Monovision Traditional Monovision Versus Modest Monovision Neurophysiology Optics and IOLs Spectacles Multifocal Intraocular Lenses Accommodative Intraocular Lenses Monofocal IOLs Extended Depth of Focus IOLs History Incorporating Modest Monovision in Your Practice Compromises Patient Selection and Counselling Testing for Dominance Contraindications Disruption of Binocular Fusion Impaired Acuity Poor Comprehension Management of Dissatisfied Patients Address the Alternatives Broach Monovision Choose Distance Demonstrate Defocus Conclusion References Surgical Techniques 44 Phacodynamics Acknowledgements Bibliography 45 General Cataract Surgery Side Ports Main Incision Hydrodissection and Hydrodelineation Phacoemulsification Divide and Conquer Implantation of the Iintraocular Lens Hydration References 46 Lens Surgery for Particularly Soft Lenses 47 Surgical Techniques—Cataract Surgery in Very Hard Lenses Choice of Anaesthesia in Dense Cataract Surgery Phacoemulsification in Dense Cataracts Incision and Anterior Capsulorhexis Extracapsular Cataract Extraction (ECCE) and Manual Small Incision Cataract Surgery (MSICS) for Dense Cataract Emulsification Newer Techniques/Devices for Dense Cataract Surgery Endocapsular Manual Nucleus fragmentation in Phacoemulsification Complications During Dense Cataract Surgery Conclusion References 48 Posterior Subcapsular Cataract Pre-operative Considerations Conclusion References 49 Cataract Surgery in Short and Long Eyes Hyperopes Preoperative Discussion, Examination, and Planning Intraoperative Considerations Postoperative Follow Up Myopes Preoperative Discussion, Examination, and Planning Intraoperative Considerations References 50 Reduction of Astigmatism by Corneal Incisions References 51 Special Surgical Features When Using Toric and Multifocal Intraocular Lenses Special Surgical Features When Using Multifocal Intraocular Lenses References 52 Corneal Complications and Management Associated with Cataract Surgery Dry Eye Incision-Associated Complications Corneal Endothelial Damage References 53 Iris Complications and Management in Cataract Surgery The Narrow, Rigid Pupil Surgical Management of Narrow, Rigid Pupils The Narrow, Atonic Pupil in IFIS Surgical Management of IFIS Iris Prolapse Conclusion References 54 Zonular Disorders and Management in Cataract Surgery Introduction References 55 Complication Management in Case of Damage to the Lens Capsule or Loss of Lens Fragments Introduction References 56 Extracapsular and Intracapsular Cataract Extraction Introduction References 57 Biaxial (Bimanual) Microincisional Cataract Surgery References 58 Exchange of Intraocular Lenses Introduction Explanting the Lens from the Capsular Bag References 59 Implantation of Anterior Chamber Lenses Introduction About the Anterior Chamber Lens Prerequisites for Implantation Preparation of the Implantation Implantation References 60 Sulcus IOLs Introduction Indications/Contraindications Surgery Technique Choice of IOL Complications Conclusion References 61 Retropupillary Iris Claw Intraocular Lens Implantation for Aphakia Correction Introduction Historical Information The Technique Using Standard Instruments (“Artisan Tweezers”) Complications Comparison with Other Implants and Implantation Techniques Contraindications/Disadvantages References 62 Implantation of Scleral-Fixed Intraocular Lenses Scleral Pocket Fixation of 3-Piece IOLs Scleral Suture Fixation of 1-Piece IOLs Modified Yamane Scleral Fixation of 3-Piece IOLs Multi-point Scleral Fixation of IOLs References 63 Cataract Surgery After Trauma Introduction Injury Mechanisms Cataract in Open Globe Injuries Cataract in Closed Globe Trauma (Contusion) Timing of Cataract Surgery Advantages and Disadvantages of Primary Lens Extraction Advantages and Disadvantages of Secondary Lens Extraction Primary Aphakia and Secondary Implantation Surgical Technique Traumatic Cataract Extraction Postoperative Complications Traumatic Cataract in Children Summary References 64 Paediatric Cataract Surgery Introduction Immediate Versus Delayed Sequential Surgery Continuous Curvilinear Capsulorhexis (CCC) Other Anterior Capsulotomy Techniques Special Case of Intumescent White Cataracts Hydrodissection and Hydrodelineation Lens Aspiration and Lensectomy Posterior Capsulotomy Anterior Core Vitrectomy Aphakia or Pseudophakia? Lens Power Traditional IOL Implantation Technique Associated with High VAO and Reoperation Rate in Young Children Optic Capture and BIL Technique to Reduce Reoperations Due to VAO Surgical Correction of Aphakia Completing the Operation Importance of Data Bases for Progress Summary References 65 Cataract Surgery for Corneal Pathologies References 66 Cataract Surgery Strategies for Iris Pathologies Conclusion References 67 Cataract Surgery in Special Circumstances—PEX and Zonular Weakness References 68 Cataract Surgery for Retinal Diseases 1. Special intraoperative features of cataract surgery in retinal diseases References 69 Cataract and Glaucoma Preoperative considerations: Intraoperative considerations: Postoperative notes: References 70 Cataract Surgery in Patients with Radiation-Induced Cataract Fundamentals of Radiobiology Frequency of Cataract Development After Radiotherapy of the Eye Form of Cataract After Radiotherapy Rationales for Performing Cataract Surgery Dissemination of Tumor Cells Due to Cataract Surgery Contraindications for Cataract Surgery References Systematic Overview 71 Cataract Surgery in Eyes with Uveitis Introduction Preoperative Goals Surgical Procedure Type of Intraocular Lens Postoperative Care References 72 Systematic Overview of Cataract Surgery Intraoperative Complications Postoperative Complications References 73 Aspheric Intraocular Lenses Introduction Aspheric IOL Design Efficacy of Aspheric IOLs Drawbacks of Aspheric IOLs Benefits of Spherical Aberration Selecting the Correct IOL for the Patient Summary References 74 Systematic Overview of Toric Intraocular Lenses Introduction Toric IOLs-Intracapsular Positioning of the Toric IOL Marking of the Target Axis Manual Marking Techniques Digital-Assisted Marking Techniques Intraoperative Alignment Residual Astigmatism and Postoperative Rotation Additives IOLs and Special Lenses Summary References 75 Systematic Overview of Monovision Complications Conclusion References 76 Systematic Overview of Multifocal Intraocular Lenses Complications and Postoperative Problems Conclusion References 77 Intraocular Lens Fixation in the Ciliary Sulcus: A Systematic Overview Quality of Available Data and Evidence Choice of IOL Power Results and Complication Rate References 78 Systematic Overview on Secondary Intraocular Lenses Main Text Secondary IOL Implantation Secondary Implantation in the Capsular Bag Secondary Implantation in the Ciliary Sulcus Iris Fixation Scleral Fixation Sutured IOL Scleral Fixation Sutureless Scleral Fixation Long-Term Stability Conclusion References 79 Systematic Review of Add-on Intaocular Lenses Data on Correction of Refractive Errors in Pseudophakic Patients by Add-on Iols Correction of Astigmatism Conclusion Add-on Intraocular Lenses for Correction of Presbyopia Conclusion Data on Dysphotopsia After Add-on Implantation References 80 Systemic Overview of Experimental Lens Surgery Introduction Accommodative IOL Artificial Intelligence Green Cataract Surgery and Sustainability Electrical IOL Devices Lens Regeneration Following Lens Extraction Drug Eluting IOL Pharmacological Cataract Therapy–Molecular Biology Political and Economic Innovation Projects Postoperative Non-invasive Adjustment of Dioptric IOL Power Robotics 3D-Printed IOL Conclusion References Postoperative Management 81 Perioperative Management in Cataract Surgery Corticosteroids Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Antibiotics Virustatics Antiglaucoma Agents Osmotic Agents References 82 Posterior Capsular Opacification Introduction References 83 Refractive Surprise After Lens Surgery—Error Prevention and Problem Management Cases with a History of Previous Surgery Biometry Errors IOL Calculation Formulas Intraoperative and Postoperative Complications Sources of Error When Implanting Toric Artificial Lenses Human and Technical Failure References 84 Management of the Unhappy Patient Introduction Reasons for Dissatisfaction: Monofocal IOLs Multifocal IOLs Avoiding Problems by Adequate Preoperative Discussions and Ocular Measurement Why are Patients Unhappy? Distance Vision Less Than Expected or “Waxy” Reading Vision Less Than Expected and Poor in Low Light Poor Intermediate Vision Dark Shadows or Flickering Lights in the Temporal Field Glare and Haloes A Structured Approach to Provide Solutions for the Unhappy Patient Distance Vision Issues Near Vision Problems Poor Intermediate Vision Negative and Positive Dysphotopsias Glare and Haloes In Summary References 85 Management After Opacification of Intraocular Lenses Calcification in Hydrophilic IOLs Primary IOL Calcification Secondary IOL Calcification Glistenings References 86 Management After Dislocation of an Intraocular Lens Introduction Procedure for Dislocated IOL References 87 Treatment of Postoperative Intraocular Pressure Increase References 88 Treatment of Postoperative Cystoid Macular Edema Etiology Diagnostics Course Risk Factors Therapy References 89 Postoperative Inflammation References 90 Dry Eye Management in Patients Undergoing Cataract Surgery Epidemiology Diagnosis of Dry Eye Treatment of DED in Patients Undergoing Cataract Surgery General Treatment Principles Preoperative Management Intraoperative Management Postoperative Management References Femtoseconds Laser-Assisted Lens Surgery 91 Basic Principles of the Femtosecond Laser-Based Tissue Surgery Introduction Laser Beam Propagation Dielectric Breakdown Shock Waves and Cavitation Bubble System Optimization Femtosecond Laser Cataract Laser Systems Patient Interface and Docking Imaging Capsulotomy Lens Fragmentation Corneal Incisions Newer Technologies References 92 Corneal Incisions with the Femtosecond Laser Conclusion References 93 Capsulotomy Using the Femtosecond Laser Special Techniques Mature Lenses Posterior Capsulotomy References 94 Fragmentation with the Femtolaser References 95 Special Features of Cataract Surgery Using the Femtosecond Laser Conclusion References 96 Comparison of Conventional Lens Surgery to Femtosecond Laser-Assisted Lens Surgery Conclusion References Phakic Intraocular Lenses 97 Overview and Indications of Phakic IOL Overview of Phakic IOL Phakic IOL Versus LVC Presbyopia, Reversibility and Effects on Biometry Choosing the Right Implant—Sizing and Vaulting Special Features of Toric ICL Conclusion References 98 Surgical Techniques for the Use of Phakic Intraocular Lenses Conclusion References 99 Management of Surgical Complications When Implanting Phakic IOLs References 100 Systematic Overview of Phakic Intraocular Lenses Overview Phakic Intraocular Lenses Results After Implantation of Phakic Intraocular Lenses Safety/Effectiveness Predictability/Stability Postoperative and Long-term Complications of Phakic Intraocular Lenses Surgically Induced Astigmatism (SIA) Corneal Endothelial Cell Loss Pigment Dispersion and Lens Coatings Chronic Inflammation and Uveitis Pupil Ovalization and Iris Retraction Pressure Increase and Pupillary Block Lens Rotation, as Well as Lens Power and Position Cataract Formation Retinal Detachment Further Complications Conclusion References Other sources: Index