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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5187_Библиотеки_им_академика_М_И_Перельмана.pdf
Financial Disclosures
Dr.Amar Agarwal has no financial or proprietary interest in the materials presented herein.
Dr.Ashar Agarwal has no financial or proprietary interest in the materials presented herein.
Dr. Ashvin Agarwal has no financial or proprietary interest in the materials presented herein.
Dr.Athiya Agarwal has no financial or proprietary interest in the materials presented herein.
Dr. Masayuki Akimoto has no financial or proprietary interest in the materials presented herein.
Dr.BrandonD. Ayres has no financial or proprietary interest in the materials presented herein.
Dr. SonalS. Chaugule has no financial or proprietary interest in the materials presented herein.
Dr.RobertJ. Cionni has no financial or proprietary interest in the materials presented herein.
Dr.AlanS. Crandall has no financial or proprietary interest in the materials presented herein.
Dr.Paul T. Fin ger has no financial or proprietary interest in the materials presented herein.
Dr.SadeerB. Hannush has no financial or proprietary interest in the materials presented herein.
Dr.RichardS. Hoffman has no financial or proprietary interest in the materials presented herein.
Dr.Santosh G. Honavar has no financial or proprietary interest in the materials presented herein
Dr.Dhivya Ashok Kumar has no financial or proprietary interest in the materials presented herein.
Dr. Ravi Kumar K V has no financial or proprietary interest in the materials presented herein.
Dr.Mami Kusaka has no financial or proprietary interest in the materials presented herein.
Dr.Yuri McKee has no financial or proprietary interest in the materials presented herein.
Dr.KevinM. Miller has no financial or proprietary interest in the materials presented herein.
Dr. Priya Narang has no financial or proprietary interest in the materials presented herein.
Dr.Vladimir Pfeifer has no financial or proprietary interest in the materials presented herein.
Dr.StevenG. Safran has no financial or proprietary interest in the materials presented herein.
Dr.Michael E. Snyder is a consultant for and receives royalties from HumanOptics AG and is a
shareholder in VEO Ophthalmics.
- 175 -
176 Financial Disclosures
Dr.William B. Trattler has no financial or proprietary interest in the materials presented herein.
Dr.Claudio Trindade has a licence agreement with Morcher GmbH.
Dr.DavidT. Truong has no financial or proprietary interest in the materials presented herein.
Dr.Shin Yamane has no financial or proprietary interest in the materials presented herein.
Index
Ahmed Gonio Lens, 15
air tamponade, pupilloplasty in achieving, 72
anesthesia, in Siepser technique, 22
aniridia, 3
acquired, 133
annual glaucoma screening in, 133
congenital, 6, 129
degree of visual impairment with,
129-130
evaluation for, 133
iatrogenic, 133, 134
incomplete, 89
management of, 130-132
with subluxated cataract, 130, 131
traumatic, 130
aniridia intraocular lens, 90-91
glued, 132, 133
in situ, 6
aniridia rings, 93
aniridic capsular tension rings, 27-28
anterior chamber, blood clot in, 119, 120
anterior chamber maintainer, 9, 39
in glued intraocular lens procedure, 74-77
anterior chamber wash, 120
anterior segment optical coherence
tomography, 63-64, 67, 69
for iris cysts, 167
for iris tumor, 162
argon laser peripheral iridoplasty, 68
artificial iris
fixation of, 95
sutured, 94
artificial iris device, 15
Ashley’s book of knots, 37
biometry, with cerclage suture, 29
blindness, angle-closure glaucoma in, 65
blunt ocular trauma, 6
in iridodialysis, 47
pupil repair for, 16
Bonn Micro Iris Hook, 146
bottle rocket injury, 90
brachytherapy, 165
camera obscura, 153
capillary hemangioma, 165
capsular tension rings, 93
capsulorrhexis, iris prosthesis insertion with, 93
cataract
after pupilloplasty, 40
with aniridia, 130-131
with iris damage, 22
cataract surgery, with cerclage suture, 29
cautery, 149
cerclage suture, placement of, 150
chord mu, 140
cigarette lighter injury, 11
- 177 -
178 Index
ciliary zone, 4, 5
Cionni ring fixation, modified sewing
machine technique in, 57
Cionni technique, for iris coloboma repair, 25
collarette, 4
coloboma, 3, 165
with cataract, 6
repair of, 13
Cionni technique in, 25
modified McCannel suturing in, 16
modified sewing machine technique
in, 57
coloboma shield capsular tension ring, 131
computed tomography, for iris tumor, 162
corectopia, 120-121
corneal edema, with massive inflammatory
response, 123
corneal tattooing, 13
corneal tissue, suture passing through, 40
curved needles, 145
CustomFlex Artificial Iris, 15
cutting needles, 145
cystic lesions, 163
cysts, 166
asymptomatic, 167, 168-169
case presentation of, 170-171
diagnosis and complications of, 167-169
free-floating, 166
presentations of, 166-167
primary and secondary, 166
recurrent in child, 166
diffraction limit, 154
double-flanged polypropylene suture, 115
double-needle scleral intraocular lens, 95
double-needle technique, flanged intrascleral
intraocular lens fixation with, 84-85
ectopia lentis, 130
endothelial damage, after pupilloplasty, 40
endothelial keratoplasty
glued intraocular lens with, 73-77
single-pass four-throw pupilloplasty in,
72-73
enucleation, 166
eye
compartmentalizing, 71-85
penetrating trauma to, 5
fibrin membrane, 122
flanged intrascleral intraocular lens fixation,
with double-needle technique, 84-85
fluorescein angiography, 162
foreign body, 165
freckle, 163
Fuch’s crypts, 4
furrows, 4
glaucoma
angle-closure, 62
investigations in, 63-64
pupilloplasty for, 64-66
surgical consideration for, 62-63
surgical pupilloplasty in, 68-69
surgical technique for, 64
aniridia and, 129
management of, 130
screening for in patients with aniridia, 133
secondary, 62-66
visual loss with, 129-130
glued intraocular lens
advantages of, 78-80, 125
aniridia, 132, 133
with endothelial keratoplasty, 73-77
pre-Descemet’s endothelial keratoplasty
and single-pass four-throw
pupilloplasty with, 81-83
Yamane technique and, 71-72
glued iris prosthesis, 8
Goldmann applanation tonometry, 63
hang-back (non-appositional) technique, 48
heterochromia, 165
Hoffman’s technique, 48
advantages of, 51-52
principle of, 48
surgical procedure in, 49, 50-51
HumanOptics device, 91
hyphema, 118
after pupilloplasty, 40
grading of, 119
management of, 120
total, 119
hypotony, with glued intraocular lens and
endothelial keratoplasty, 77
iatrogenic iris trauma after pupilloplasty, 40
IC-8 pinhole intraocular lens, 153, 155
intraocular diathermy, 149, 150
intraocular forceps, 147
intraocular hemorrhage, after pupilloplasty, 40
intraocular lens
aniridic, 27-28
fibrin membrane on, 122
Index 179
flanged intrascleral fixation of, 84-85
glued, 32, 33, 71-72
advantages of, 78-80, 125
with endothelial keratoplasty, 73-77
with pre-Descemet’s endothelial
keratoplasty and single-pass four-
throw pupilloplasty, 81-83
pigment dispersion on, 123
pinhole, 153-159
relocation of, 57
small aperture, 155, 156
subluxated, 33
intraocular lens tilt, cyst causing, 166
intraocular pressure, reduction of, 9
intraocular snare, 147
iridectomy, for iris tumors, 165
iridocorneal endothelial syndrome, 165
iridocyclectomy, for iris tumors, 165
iridodialysis, 13
after iris repair, 120
after pupilloplasty, 40, 41
blunt trauma in, 47
congenital, 47
iatrogenic, 47, 114, 120
complication and management of,
125-126
massive, 98, 99-101
minimal, 98, 110-111
moderate, 98, 101-103, 107-110
post-traumatic, 7
single-pass four-throw pupilloplasty
technique for, 105-106
traumatic, with subluxated lens, 134
iridodialysis repair, 55
complications of, 54
external approach to, 54
hang-back (non-appositional) technique
in, 48, 104-105, 112-113
Hoffman’s technique in, 48-52
indications for, 47
modified sewing machine technique in, 57
with riveting technique with
double-flanged polypropylene suture,
115
sewing machine technique in, 53-54,
55, 56
sutureless technique in, 54
through scleral pocket, 52-53
twofold technique in, 97-112
case presentations of, 114-115
iris
abnormalities of, 5
anatomy of, 3-4
atrophy of, 118, 165
with Urrets-Zavalia syndrome, 62
histology of, 5
normal architecture of, 4
partial or total loss of, 13
prolapsed, 125
replacement devices for, 27-28
iris arteriovenous malformation, 165
iris cavernous hemangioma, 165
iris cerclage suture, 7, 28
case presentation for, 33
final steps in, 31
materials for, 29
surgical technique of, 30-32
tying knot in, 31, 32
iris defects
congenital, 3
large, artificial iris device implantation
for, 87-95
physical examination for, 28-29
suture repair of, 87
types of, caused by trauma, 13-14
iris dialysis repair, 9
iris holes, 13
iris knot, imaging of, 10
iris manipulation, 13
iris pigment epithelial adenocarcinoma, 165
iris pigment epithelial adenoma, 165
iris pigment epithelial cysts, 163
removal and defect repair for, 170-171
iris prosthesis devices, 8, 91-92
case presentations of, 93-95
in managing large iris defects, 87-91
silicone, 27-28
iris reconstruction, 13
categories of, 3, 87
iris repair
advantages of, 9
case presentations of, 11, 125-126
complications and limitations of, 119-123
prevention of, 117-118
history and techniques of, 7-8
indications for, 5-7
with iris cerclage suture, 28-33
medical history before, 118
neovascular conditions in, 118
objective of, 9
tools for, 145-151
180 Index
iris root disinsertion, 23
iris sphincter tears, 5
iris tissue
cheesewiring of, 118, 122, 123
function of, 3
functional change of, 119
handling of, 55
preventing tears in, 23
salient points in repair of, 8-9
stretching and pulling of, 117
tethering of, 118, 122
iris varix, 165
Kamra pinhole corneal inlay, 153, 154
keratoconus, pinhole pupilloplasty in, 143
keratoplasty
biomechanical and kinetic properties of, 78
cyst following, 166-167
knot mechanics, 37-38
Kuglen hook, 146
laser peripheral iridectomy, 62
laser peripheral iridotomy, 68
lens
complete dislocation of, 130
congenital subluxated, 130
light reflex, Purkinje image from, 138
limbal stem cell deficiency, with congenital
aniridia, 132
magnetic resonance imaging
for iris cysts, 168
for iris tumor, 162
Mark V implant, 153
mattress sutures, 145
McAhmed suture technique, modified, 18
McCannel needle, 7
McCannel suture technique, 14, 15, 146
modified, 14-15, 17, 31
in pupil repair, 16-17
medulloepithelioma, 165
melanocytic iris tumors, 163-164
melanocytoma, 164
melanoma, 164
ring and diffuse, 164
metastatic iris tumors, 165
microfinger-style forceps, 147
microforceps, 147
serrated, 147, 148
microhemangioma, 165
microhemangiomatosis, 165
microhook, 146
microscissors, 147-148
straight and curved, 147, 148
modified capsular tension rings, 88-89
implantation of, 93
Morcher devices, 89-90
mydriasis, traumatic, 6, 13
mydriatic, 40
needles, 145-146
neuroepithelial cysts, 163
nevus, 163-164
nonmelanocytic tumors, 164-165
nonneoplastic lesions, 165
opaque ring insertion, 13
Ophtec devices, 90-91
ophthalmic viscosurgical devices, 149-150
in cerclage suturing, 29-30
increased intraocular pressure with, 62
optic capture, 22
ophthalmic viscosurgical device cannula,
29-31
paracentesis
in iris repair, 23
in single-pass four-throw pupilloplasty, 36
PAX6 gene mutation, 129
penetrating injury, 92
penetrating keratoplasty, Urrets-Zavalia
syndrome after, 67
peripheral anterior synechiae, 15, 61
in secondary glaucoma, 62
phacodonesis, 130
photophobia, with glaucoma, 129-130
pinhole intraocular lenses, 153
background for, 153-154
benefit of, 156
indications for, 156
visual field with, 157, 158
pinhole pupil, 137
multiple quadrant approach to create, 139
single-pass four-throw technique to
create, 138
vitrector to create, 151
pinhole pupilloplasty, 9
pre- and postoperative images of, 139
plateau iris syndrome, 69
polycoria, 120-121
polypropylene sutures, 91, 145, 146
Index 181
posterior chamber intraocular lens, 92
postoperative radial keratotomy, 156
XtraFocus intraocular lens in, 159
pre-Descemet’s endothelial keratoplasty
with glued intraocular lens, 73-83
with pinhole pupilloplasty, 142
with single-pass four-throw pupilloplasty,
72, 74, 81-83
proton beam irradiation, 165
pseudophakic bullous keratopathy, 75-76, 79
pupil
abnormalities of, 5
anatomy of, 5
functions of, 71
non-dilating, 122, 124
persistently dilated postoperative, 61
reconstruction of, 35
pupillary cerclage, 16
pupillary phimosis, 124
pupillary ruff, 4, 5
pupillary stretching, 62
pupilloplasty, 5
in achieving effective air tamponade, 72
advantages of, 9
in angle-closure glaucoma, 68-69
in compartmentalizing eye, 71-85
complications and limitations of, 119-123
preventing, 117-118
indications for, 5, 39
mechanism of action of, 62
pinhole
advantages of, 141
case presentation of, 143
chord mu and, 140
definition of, 137
depth of field vs pupil size in, 141
pre-Descemet’s endothelial
keratoplasty with, 142
principle of, 137-138, 140
Purkinje images in, 138
surgical technique for, 138-139
relative contraindications to, 39
single-pass four-throw technique, 23,
35-37, 40-42, 105-106
to achieve pinhole pupil, 139
advantages of, 40
for angle-closure glaucoma, 64-66
case presentations for, 44-45
complications of, 40
in endothelial keratoplasty, 72-74
indications for, 39
knot mechanics in, 37-38
with pre-Descemet’s endothelial
keratoplasty and glued
intraocular lens, 81-83
relative contraindications for, 39
surgical technique in, 39-40
Yamane technique with, 45
single suture loop, 7
in Urrets-Zavalia syndrome, 67
vital step in, 9
Purkinje images, in pinhole pupilloplasty, 138
Rayleigh criterion, 154
refractive surprise, pinhole pupil for, 151
riveting technique with double-flanged
polypropylene suture, 115
scleral fixated aniridia intraocular lenses, 132
scleral fixated intraocular lenses, 57
scleral pocket technique, 48-52
advantages of, 51-52
iridodialysis repair through, 52-53
scleral suture fixation, 90
serrated forceps, 147, 148
sewing machine technique, 53-56
clinical image of, 55
modified, 57
principle of, 53
surgical procedure for, 53-54
Siepser sliding knot technique, 7, 14, 146
anesthesia in, 22
materials for, 21
surgical approach in, 22
surgical technique in, 23
variations of, 23-24
silicone oil, in secondary glaucoma, 62-63
single-pass four-throw approach. See
pupilloplasty, single-pass four-throw
technique
Sinskey hook, 146
sliding knots, 21, 35, 149
Siepser, 7, 14, 21-24, 146
small aperture intraocular lenses, 155, 156
Snellen visual acuity, as function of pupil size
and defocus, 154
solid epithelial tumors, 165
spatulated needles, 145
sphincter tears, 13
Stiles-Crawford effect, 137-138
straight needles, 145
stromal cysts, 163
182 Index
subluxated intraocular lens, 33
surgical hooks, 146
suture loop, non-sliding of in anterior
chamber, 123
suture material, 145
suture recovery devices, 146-147
sutureless iridodialysis repair, 54
taper-cut needles, 145
through scleral pocket, 52-53
transillumination defects, 120
trauma, iris defects caused by, 13-14
triumvirate technique, single-pass four-throw
pupilloplasty in, 41-42
trocar anterior chamber maintainer, 39
in glued intraocular lens procedure, 74
in single-pass four-throw pupilloplasty,
42-43
trocar-assisted hang-back technique, 112-113
TSK Ultra Thin Wall Needle, 84
tumors, 161
ancillary examination of, 162-163
benign vs malignant, 165-166
biopsy of, 163
classification of, 162, 163-165
clinical evaluation of, 161-162
diagnostic features of, 161-163
management of, 165-166
twofold technique, 97-98
case presentations of, 114-115
massive, 98, 99-101
minimal, 98, 110-111
moderate, 98, 101-103, 107-110
riveting technique in, 115
ultrasound biomicroscopy
for iris cysts, 167
for iris tumor, 162
Urrets-Zavalia syndrome, 9, 10, 16, 61
post penetrating keratoplasty, 67
pupilloplasty for, 64-66
surgical consideration for, 62
vascular needle, 145, 146
visual field, with pinhole intraocular lenses,
157, 158
vitrectomy, 149
for aniridia, 133
vitrector, 149
to create pinhole pupil, 151
XtraFocus pinhole implant, 153, 155-159
Yamane technique, 71-72
artificial iris with, 95
flanged intrascleral intraocular lens
fixation with double-needle technique
in, 84-85
with single-pass four-throw pupilloplasty, 45