ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Major advances in cataract extraction techniques and instrumentation have occurred over the past decade. Smaller incisions, more efficient phacoemulsifiers, and decreased surgical times are a few of the changes that have helped to alleviate postoperative inflammation, but postoperative inflammation continues to be a cause of patient discomfort; delayed recovery; and, in some cases, suboptimal visual results secondary to cystoid macular edema. This article reviews the most recent literature regarding the control of intraocular inflammation associated with cataract surgery.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Research articles on anesthesia modalities for cataract surgery are reviewed. A growing trend toward the use of topical anesthesia is apparent. Particular emphasis in the literature is given to determining the safety and efficacy of various forms of topical anesthesia using injectable anesthesia as a frame of reference. A consensus of opinion points toward the use of topical application of anesthetic drops plus intracameral unpreserved lidocaine 1% as the anesthesia modality that provides the best level of analgesia and comfort to patients while not compromising ocular safety. Several articles reporting complications of injectable anesthesia are also reviewed.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Multifocal intraocular lenses (IOLs) are increasingly becoming a part of the armamentarium of cataract and refractive surgeons. Reports show that most multifocal IOLs provide excellent visual outcomes. In one major study of a zonal progressive, refractive, multifocal design, more than 80% of patients were able to see 20/40 or better at distance and J3 or better at near, without correction. This study also found that patients' satisfaction ratings of their multifocal vision were consistently high. Although a few patients with multifocal IOLs complain of halo or glare, these symptoms can be minimized by surgical technique and appropriate selection of the multifocal IOL power.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Phakic Intraocular surgery has come a long way in the past 20 years, especially in the evolution of posterior chamber phakic intraocular lenses (PC PIOLs). Clinical trials worldwide are showing acceptable results concerning efficacy, predictability, stability, and safety. PC PIOLS are proving to be a promising option for patients with high and extreme ametropia who cannot benefit from conventional corneal refractive procedures.This article provides an in-depth examination of PC PIOLs, their origin and evolution, and the results of past and current clinical studies. Reports of historical importance and studies published since the 1990s in peer-reviewed journals, textbooks, and monthly eye magazines, as well as Food and Drug Administration preliminary clinical findings, are reviewed. Anterior chamber phakic intraocular lenses are mentioned briefly.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

With the increasing number of keratorefractive surgical procedures, an increasing number of cataract surgeries in eyes after keratorefractive surgery is anticipated within a few decades. Although cataract extraction seems to be feasible without major technical obstacles, intraocular lens (IOL) power calculation turned out to be problematic. Insertion of the measured average K-readings (= “central corneal power” = keratometric diopters) after myopic radial keratotomy (RK), photorefractive keratectomy (PRK), or laser in situ keratomileusis (LASIK) into standard IOL power-predictive formulas commonly results in substantial undercorrection and postoperative hyperopic refraction or anisometropia. In this article, the major reasons for IOL power miscalculations (which are different for RK versus RRK/LASIK) are discussed based on model calculations and based on case series of cataract surgeries, methods for improved assessment of keratometric diopters as the major underlying problem are exemplary illustrated, and finally a clinical step-by-step approach to minimize IOL power miscalculations status after corneal refractive surgery is suggested. The “clinical history method” (i.e.,subtraction of the spherical equivalent [SEQ] change after refractive surgery from the original K-reading) should be applied whenever refraction and K-reading before the keratorefractive procedure are available to cataract surgeons. In addition, more than one modern third-generation formula (e.g.,Haigis, Hoffer Q, Holladay 2, or SRK/T) but not a regression formula (e.g.,SRK I or SRK II) should be applied and the highest resulting IOL power should be used for the implant.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

This article reviews some of the basic optics of astigmatism and the correction of astigmatism with cylindric lenses. A simple model of the conoid of Sturm is demonstrated, and an ideal position for the conoid is postulated. The orientation of the conoid shows that leaving patients with some simple myopic “against-the-rule” astigmatism is beneficial to near work, whereas “with-the-rule” astigmatism is beneficial for distant viewing. Surgeons should be less aggressive with patients with with-the-rule and against-the-rule astigmatism and more aggressive with oblique astigmatism. The toric intraocular lens (IOL) should be positioned on axis or, if slightly off axis, err on the side away from the vertical or horizontal meridian so that the resultant cylinder is more vertical or horizontal. Clinically significant rotation of the toric IOL occurs in a few cases, but these can be easily rerotated. Rerotation should be done between the first and second weeks after primary implantation.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Over the past 15 years, lens implant surgery in children has disseminated so much that it is no longer a controversial issue. It has become rather a specialized topic in the widespread field of lens implantation in the general population. To match the excellent results seen in adults, issues such as the surgical technique, the choice of the lens, and dioptric power of that lens, are constantly being refined and adapted to children's growing eyes. Scleral tunnels and small, self-sealing corneal incisions are being replicated in children to benefit from their advantages. Polymethyl methacrylate material remains unrivalled from the point of view of safety and longevity in the human eye. Intraocular lenses (IOLs) with an overall diameter of 12 mm can safely be used in nonmicrophthalmic eyes of children more than 3 years of age. Several investigators now recognize the need for smaller pediatric IOLs for neonates, toddlers, and microphthalmic eyes. Fortunately, modern IOLs are smaller today than they were 15 years ago. The accumulating evidence on the myopic shift that occurs in pseudophakic children have led to an almost unanimous agreement that the IOL power should aim for a certain amount of hypermetropia at time of surgery. The residual refractive error can be corrected with spectacle glasses that are adjusted throughout childhood. The goal is to start with hypermetropia in childhood that will convert into emmetropia or mild myopia in adulthood.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Posterior capsule opacification (PCO) is the most common complication following primary cataract surgery. Advances in intraocular lens (IOL) designs that have reduced the amount of PCO following surgery have been made. The understanding of how the IOL design effects PCO has also advanced. Lenses that provide a mechanical barrier between it and the posterior lens capsule seem to inhibit PCO to a greater degree. Intracapsular rings are now being explored to test and enhance this barrier effect. Major advances in the elimination of lens epithelial cells at the time of surgery especially by pharmacologic means have also been made. An immunotoxin specific for human lens epithelial cells shows promise and is under latter phase clinical development.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Cystoid macular edema (CME) remains a troublesome problem after cataract surgery and other types of ocular surgical procedures. It is recognized as the most frequent cause of decreased vision in patients following cataract surgery. Although the disease was first described more than 40 years ago, its cause is unclear, and all available therapeutic interventions, mainly based on theories regarding the pathogenesis of the condition, are of doubtful effectiveness and are still far from being satisfactory. Most published literature on the incidence and treatment of CME consists of small, retrospective case series and cannot provide reliable answers as to whether a given factor or intervention is associated with the occurrence or outcome of the disease.

ISSN:1040-8738    

出版商:OVID    

年代:2000

数据来源: OVID