Ординатура / Офтальмология / Английские материалы / Modern Cataract Surgery_Kohnen_2002

Ophthalmic viscosurgical device (continued) applications

anterior hyaloid face dissection from posterior capsule 19

capsulorhexis 20–22 cornea transplantation 20

intraocular lens implantation 20 partial filling, anterior chamber 20 phaco tumble techniques 19 trauma 20

trypan blue utilization 20, 22, 23 viscomydriasis 20

vitrectomy 21 wound blockade 21

classification 14, 15 dispersive-cohesive viscoelastic soft shell

technique 14, 16 pseudoplasticity curves 18, 19 removal techniques 23, 24 types 13, 16

ultimate soft shell technique 21–23 viscoadaptive response to fluid

turbulence 16–18 Optical coherence biometry,

see also IOLMaster

advantages over ultrasound biometry 125, 128, 129, 132–135, 137

dual beam partial coherence interferometry 132–136 historical perspective 110

intraocular lens constant optimization 125–127

lens-capsule distance measurement 137, 138

limitations 129 principles 132, 133

pseudophakic measurements 136–139 reference system 122

refractive outcome, cataract surgery 133–136

ultrasound axial length comparison and conversion 120–123

Orbscan topography system accuracy 142–144 instrumentation 141, 142 problem cases 143, 145 white-to-white measurement 141

Partial coherence interferometry, see Optical coherence biometry

Passport, foldable intraocular lens injection 149, 150, 153

Phaco chop advantages 77, 78

anterior chamber phacoemulsification comparison, see Anterior chamber phacoemulsification

chopping technique 76 complications 77

historical perspective 74, 75 instrumentation 75

patient selection 75 principles 75, 80 training 77 ultrasound assistance

Fuchs’ dystrophy case studies 81, 82 irrigation forces 82, 83

rationale 80 technique 80, 81

Phacoemulsification, see Anterior chamber phacoemulsification, Capsular tension ring, Phaco chop, Phacotmesis, Staar Wave, Tilt and tumble phacoemulsification, Viscoelastics, Vitreous cavity phacoemulsification

Phaco-out, see Anterior chamber phacoemulsification

Phacotmesis indications 42, 43 principles 41

technique, phacoemulsification 41 tip size effects 42

Piggyback intraocular lens implantation, see Intraocular lens

Posterior capsule opacification acrylic-hydrophilic intraocular lens

studies of square edge prevention lens characteristics 196, 197 opacification, first-generation lenses

195

patient groups and outcomes 197, 198, 200

square edge concept 195 surgical technique 197

assessment techniques 200, 203, 204

capsular tension ring effects 116, 117, 196

incidence following lens implantation 204, 205

lens epithelial cell migration 195, 200 polyfluorocarbon-coated intraocular lens

study

functional outcomes 206, 207 opacification assessment 202–206 rationale 202

study design 202, 203 Scheimpflug imaging 190, 192

Retina, protection in vitreous cavity phacoemulsification 105

Scheimpflug imaging foldable lens imaging

anterior chamber depth 189, 190 decentration 189–191

lenses for evaluation 187, 189, 191 posterior capsule opacification 189,

192 technique 189 tilt 189–191

historical perspective 187

Sensar, foldable intraocular lens injection 149

Staar Wave

conventional surgical features 32, 33 instrumentation 32, 33

limitations of current ultrasonic tips 33, 34

Sonic technology advantages 34–36, 39 SuperVac tubing 36, 37, 39, 40

Wave Powertouch user interface 37–39

Tetracaine, topical anesthesia, cataract surgery 3

Tilt and tumble phacoemulsification advantages 54

capsulorhexis 44, 45, 52, 53 closure 51

corneal incision and approaches 49–51 cortex removal 55

historical perspective 44–46 hydrodissection 53–55

indications 46, 47 keratotomy 51, 52

posterior lens chamber seating 56 postoperative care 57 preoperative preparation

anesthesia 47, 48 aperture drape 48 periocular prep 48

speculum separation, lids 48, 49 Storz Millennium utilization 55 variations in technique 57, 58 viscoelastic

injection 53, 54, 56 selection 52

Topical anesthesia, cataract surgery advantages over injection 2 bilateral instillation 6

clinical experience, small incision surgery 8, 9

complications management 7 historical perspectives 1 instillation schedule 6 intraocular irrigation 6, 9 lidocaine

formulations 3, 4 gel 7

intraocular penetration 4, 5 side effects 5

sponges 8 systemic levels 4, 5 toxicity 5

patient selection and instructions 6 postoperative instructions 7 receptor block principles 2, 3 requirements 2

surgical technique 6, 7, 10 tetracaine 3

tilt and tumble phacoemulsification 47, 48

Trypan blue

anterior capsule visualization, mature cataract surgery 89

utilization, ophthalmic viscosurgical device 20, 22, 23

Ultimate soft shell technique, ophthalmic viscosurgical device utilization 21–23

Ultrasound, see Phaco chop, Phacoemulsification, Staar Wave

Ultrasound biometry accuracy 131

applanation versus immersion axial eye length measurements 131, 210

optical axial length comparison and conversion 120–123

optical coherence biometry comparison 125, 128, 129, 132–135, 137

piggyback intraocular lens implantation measurements 210

Unfolder, foldable intraocular lens injection 149, 151

Viscoadaptive, see Ophthalmic viscosurgical device, Viscoelastics

Viscoelastics classification 25

cornea guttata comparative study of phacoemulsification

central corneal thickness outcomes 27–30

central endothelial cell outcomes 27, 28

study design 26, 27, 29 surgical technique effects on

endothelial impairment 29

viscoelastic physical and chemical properties 26, 30

surgical trauma protection 28

tilt and tumble phacoemulsification injection 53, 54, 56

selection 52

Vitreous cavity phacoemulsification advantages over nuclear extraction 103,

104

best corrected visual acuity outcomes 101, 102, 104

complication incidence 97, 102, 103 indications 99

patient characteristics and selection 97–99, 104

posterior chamber intraocular lens implantation 102

retinal protection 105

three-port pars plana vitrectomy 99, 100

White-to-white measurement, see Orbscan topography system

Zonular dialysis

capsular tension ring indication 106, 112, 113, 117

signs of loose or broken zonules 115