Table Of ContentClinical Atlas of
Procedures in Ophthalmic
and Oculofacial Surgery
Oxford Atlases in Ophthalmology
SERIES EDITORS
Daniel M. Albert, MD, MS, FACS, RRF Emmett A. Humble Distinguished Director of the
University of Wisconsin Eye Research Institute, F.A. Davis Professor, Department of
Ophthalmology and Visual Sciences and Professor, Department of Pathology,
University of Wisconsin School of Medicine and Public Health, Madison, WI
Peter A. Netland, MD, PhD, DuPont Guerry III Professor and Chairman, Department of Ophthalmology,
University of Virginia School of Medicine, Charlottesville, VA
Clinical Eye Atlas, 2nd ed. Edited by Daniel H. Gold and Richard Alan Lewis
Clinical Atlas of Procedures in Ophthalmic and Oculofacial Surgery, 2nd ed.
Edited by Daniel M. Albert and Mark J. Lucarelli
Clinical Atlas of
Procedures in Ophthalmic
and Oculofacial Surgery
S E C O N D E D I T I O N
E D I T E D BY
Daniel M. Albert, MD, MS, FACS
Mark J. Lucarelli, MD, FACS
MA N AG I N G E D I TO R
Sarah L. Atzen, BA, MLIS
3
3
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Copyright © 2012 by Oxford University Press, Inc.
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Library of Congress Cataloging-in-Publication Data
Clinical atlas of procedures in ophthalmic and oculofacial surgery / edited by Daniel M. Albert & Mark J. Lucarelli. — 2nd ed.
p. ; cm. — (Oxford atlases in ophthalmology)
Includes bibliographical references and index.
ISBN 978-0-19-538861-9 (alk. paper)
1. Eye—Surgery—Atlases. I. Albert, Daniel M. II. Lucarelli, Mark J. III. Series: Oxford atlases in ophthalmology.
[DNLM: 1. Ophthalmologic Surgical Procedures—methods—Atlases. WW 17]
RE80.C556 2012
617.7'1—dc22 2011011769
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
This book is dedicated to Alice R. McPherson, M.D.,
in recognition of her many contributions to ophthalmology
and for her friendship and support.
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F O R E W O R D
I have known Dr. Daniel Albert and Dr. Mark Lucarelli as colleagues, scholars, and
clinicians for many years and am well versed in their breadth of experience and
high level of expertise as educators. Th eir publications in the past have been both
prodigious and erudite, covering many diff erent aspects of ophthalmology. Now they
are publishing their 2nd Edition of Clinical Atlas of Procedures in Ophthalmic and
Oculofacial Surgery, a hardback, single volume that is presented in seven Sections.
Th ese Sections include Cataract and Intraocular Lens Surgery, Refractive Surgery,
Cornea and Ocular Surface Surgery, Glaucoma Surgery, Retina Surgery, Pediatric
Ophthalmology and Strabismus Surgery, and Oculofacial Plastic, Orbital, and Lacrimal
Surgery. For this book, they have carefully selected section editors, who provide
editorial cohesion, and chapter authors who are experts and national leaders in their
fi eld and are able to transmit their knowledge eff ectively to others.
Since the 1st Edition of Clinical Atlas of Procedures in Ophthalmic Surgery in 2004, there
have been many advances, hence the need for this volume. Th is 2nd Edition is broad in
scope and brings the surgeon up-to-date in the major fi elds of ophthalmic and oculofacial
surgery. It should be relevant and appealing to a wide audience from the fi rst year resident
to the experienced surgeon. All of the chapters are new. Th e Atlas includes approximately
2,500 images/illustrations with generous use of superb color intraoperative photographs
that clearly indicate the important steps in each operation. New features include a
uniform layout with selected references and comprehensive tables in each chapter listing
indications and complications associated with various surgical procedures.
Th is Atlas has much to off er to all of those performing ophthalmic and oculofacial
surgery. Th e uniform format with outstanding color images/illustrations and clear,
concise text should make retrieval of information effi cient for the reader, whether it
is to note specifi c points or to learn a new operation. Th e ultimate benefi ciaries of the
transmission of the knowledge and skills in this excellent volume will be our patients.
Richard K. Dortzbach, MD, FACS
Professor Emeritus
Former Peter A. Duehr Chair
Department of Ophthalmology and Visual Sciences
University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin
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P R E FA C E T O S E C O N D E D I T I O N
It is an acknowledged truth that surgical skills are the most challenging and diffi cult
aspect of ophthalmology both to learn and to maintain. Ophthalmologists know that
advances in ophthalmic science and technology lead to improvements and innovations
in our surgical procedures. As a result, ophthalmologists require ever-higher levels of
knowledge and skill to provide patients with the best treatment possible.
Th e staggering breadth and continual evolution of surgical techniques in
comprehensive ophthalmology and the surgical subspecialties are both laudable and
benefi cial, but can also be overwhelming for those in the medical profession. Indeed,
mastery of this full surgical repertoire has long been impossible for any individual
surgeon. Accordingly, this book intends to assist the trainee, the comprehensive
ophthalmologist, and the subspecialist in acquiring and maintaining command of the
procedures relevant to their practice.
Specifi cally, the purpose of the Clinical Atlas of Procedures in Ophthalmic and
Oculofacial Surgery is to provide an overview of a broad range of contemporary
ophthalmic and oculofacial surgical procedures. Th e illustrations should familiarize
the reader with key intraoperative and postoperative points. Th e Atlas is not intended
to be a step-by-step manual or a standalone reference source to allow performance
of the illustrated surgical procedures. Rather, the Atlas intends to illustrate surgical
fundamentals clearly, with an emphasis on well-established and accepted procedures.
Th e fi rst edition of the Atlas originated from the text, Ophthalmic Surgery: Principles
and Techniques, which appeared in 1999. Material from that text was reorganized,
updated, and expanded by a corps of capable section editors into the Clinical Atlas of
Procedures in Ophthalmic Surgery published in 2004. Th e Atlas was well received and
has proved useful to ophthalmologists for the past seven years.
Drawing on the many recommendations, comments, and criticisms that were
kindly off ered, the new edition of the Atlas has been in preparation for two years.
We were gratifi ed to be able to recruit section editors who are recognized leaders in
comprehensive ophthalmology and in each of the subspecialty fi elds. In turn, these
surgeons wrote individual chapters and attracted an outstanding group of experts
to contribute the remainder. Th us, the new edition has been entirely updated and
revised. Th e format of the chapters has been streamlined and made more uniform.
Th e total number of illustrations has been increased to more than 2,500. Tables of
