Table Of ContentRefractive Lens Surgery
I.H.Fine
M.Packer
R.S.Hoffman (Eds.)
Editors I.Howard Fine
Mark Packer
Richard S.Hoffman
Refractive
Lens Surgery
With 170 Figures,Mostly in Colour,
and 11 Tables
123
Editors
I.Howard Fine,MD
Mark Packer,MD,FACS
Richard S.Hoffman,MD
Department ofOphthalmology
Oregon Health & Science University
1550 Oak St.Suite 5
Eugene,Oregon 97401
USA
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V
Dedication for Refractive Lens Surgery
The editors respectfully dedicate this book and those of us who were doubters have
to the many pioneers of refractive surgery learned that lesson and as a result have
who had the courage to operate on healthy enhanced the satisfaction we derive from
eyes in order to enhance the quality of life our own careers.
oftheir patients. They were right all along
VII
Preface
The first recorded time a human lens was tion. Because of the changing spherical
removed for the purpose of addressing a aberration in the lens, no matter what is
refractive error was by an ophthalmologist done to the cornea as a refractive surgery
named Fukala in 1890. We do not know modality,including the most sophisticated
what type of criticism he experienced,but custom corneal shaping,functional vision
we know that today he is a forgotten man in is going to be degraded by changing spher-
ophthalmology. The introduction ofthis as ical aberration in the lens over time.
a concept in the late 1980s by both Drs.Paul This coupled with the fact that higher
Koch and Robert Osher’s manuscripts,re- myopes and hyperopes,patients with early
sulted in considerable disdain and some cataracts,and presbyopes are not necessar-
condemnation by some of their colleagues ily good candidates for LASIK has resulted
and peers.At the time,refractive surgery in in a fresh look at lens-based refractive sur-
the United States was limited to radial ker- gery. We have seen recent improvements in
atotomy. With the development ofexcimer phakic IOL technology and utilization and
lasers came a very marked change in the at- we ourselves have been increasingly moti-
titude of eye surgeons internationally re- vated to work with lens related refractive
garding the concept of invading “healthy” surgery modalities.
tissue for refractive purposes and within a Our own work with power modulations,
relatively short period oftime,LASIK was a the IOL Master,and wavefront technology
firmly established procedure as were other IOLs has convinced us that lens-related re-
modalities ofcorneal refractive surgery. fractive surgery can give superior results.
However,we have come to recognize that Stephen Klyce, MD, the developer of
corneal refractive surgery, and especially corneal topography has demonstrated,
LASIK, has limitations. We have also using topographical and wavefront analysis
learned much in the recent past about methods, that IOL intraocular optics are
functional vision through the use of con- far superior to the optics of the most so-
trast sensitivity and an analysis of higher phisticated, customized wavefront treated
order optical aberrations. We have also cornea. We have also seen the development
learned that the cornea has constant spher- of new lens technologies including im-
ical aberration but the lens has changing proved multifocal IOLs, improved accom-
spherical aberrations. In the young,the hu- modative IOLs, light adjustable IOLs, in-
man lens compensates for the cornea’s pos- jectable IOLs, and a variety of other
itive spherical aberration,but as we age the investigational IOL technologies that sug-
changing spherical aberration within the gest unimaginable possibilities. Our own
lens exacerbates corneal spherical aberra- results with the Array and Crystalens have
VIII Preface
been very encouraging as has our work delegation.My reliance on my two partners
with bimanual micro-incision phacoemul- is evident throughout the book in the au-
sification,which I believe has allowed us to thorship ofthe chapters we have produced.
develop a refractive lens exchange tech- It is my belief that just as refractive lens
nique that sets a new standard for safety exchange represents the future ofrefractive
and efficacy. It is our belief that refractive surgery that my partners, Drs. Richard S.
lens exchange is indeed not only the future Hoffman and Mark Packer, represent the
of refractive surgery,but in many ways the new generation of leadership in anterior
procedure that will become a mainstay of segment ophthalmic surgery.
ophthalmology within the coming decades.
A major task for any editor is delegation,
and this book represents the ultimate in I.Howard Fine
X Contents
Chapter 14 Chapter 22
AcrySofReSTOR The Infiniti Vision System . . . . . . . . . . . 209
Pseudo-accommodative IOL . . . . . . . . . 137 Mark Packer,Richard S.Hoffman,
Alireza Mirshahi,Evdoxia Terzi, I.Howard Fine
Thomas Kohnen
Chapter 23
Chapter 15 The Millennium . . . . . . . . . . . . . . . . . . . . 213
The Tecnis Multifocal IOL . . . . . . . . . . . 145 Rosa Braga-Mele,Terrence Devine,
Mark Packer,I.Howard Fine, Mark Packer
Richard S.Hoffman
Chapter 24
Chapter 16 The Staar Sonic Wave. . . . . . . . . . . . . . . . 221
Blue-Light–Filtering Intraocular Richard S.Hoffman,I.Howard Fine,
Lenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Mark Packer
Robert J.Cionni
Chapter 25
Chapter 17 AMO Sovereign
The Light–Adjustable Lens. . . . . . . . . . . 161 with WhiteStar Technology . . . . . . . . . . 227
Richard S.Hoffman,I.Howard Fine, Richard S.Hoffman,I.Howard Fine,
Mark Packer Mark Packer
Chapter 18 Chapter 26
Injectable Polymer. . . . . . . . . . . . . . . . . . 173 Refractive Lens Exchange in High Myopia:
Sverker Norrby Weighing the Risks. . . . . . . . . . . . . . . . . . 233
Mark Packer,I.Howard Fine,
Chapter 19 Richard S.Hoffman
The Vision Membrane. . . . . . . . . . . . . . . 187
Lee Nordan,Mike Morris Chapter 27
Conclusion:The Future
Chapter 20 ofRefractive Lens Surgery. . . . . . . . . . . 237
Bimanual Ultrasound Mark Packer,I.Howard Fine,
Phacoemulsification . . . . . . . . . . . . . . . . 193 Richard S.Hoffman
Mark Packer,I.Howard Fine,
Richard S.Hoffman Subject Index. . . . . . . . . . . . . . . . . . . . . . . 239
Chapter 21
Low Ultrasound Microincision
Cataract Surgery. . . . . . . . . . . . . . . . . . . . 199
Jorge L.Alio,Ahmed Galal,
Jose-Luis Rodriguez Prats,
Mohamed Ramzy
IX
Contents
Chapter 1 Chapter 8
The Crystalline Lens as a Target Correction ofKeratometric Astigmatism:
for Refractive Surgery. . . . . . . . . . . . . . . 1 AcrySofToric IOL. . . . . . . . . . . . . . . . . . . 71
Mark Packer,I.Howard Fine, Stephen S.Lane
Richard S.Hoffman
Chapter 9
Chapter 2 Wavefront Technology
Refractive Lens Exchange ofSpherical Aberration . . . . . . . . . . . . . 79
as a Refractive Surgery Modality . . . . . 3 Mark Packer,I.Howard Fine,
Richard S.Hoffman,I.Howard Fine, Richard S.Hoffman
Mark Packer
Chapter 10
Chapter 3 The Eyeonics Crystalens. . . . . . . . . . . . . 87
Biometry for Refractive Lens Surgery. . 11 Steven J.Dell
Mark Packer,I.Howard Fine,
Richard S.Hoffman Chapter 11
Presbyopia – Cataract Surgery
Chapter 4 with Implantation ofthe
Intraocular Lens Power Calculations: Accommodative Posterior
Correction ofDefocus. . . . . . . . . . . . . . . 21 Chamber Lens 1CU. . . . . . . . . . . . . . . . . . 99
Jack T.Holladay Nhung X.Nguyen,
Achim Langenbucher,
Chapter 5 Berthold Seitz,M.Küchle
IOL Calculations Following
Keratorefractive Surgery. . . . . . . . . . . . . 39 Chapter 12
Douglas D.Koch,Li Wang Synchrony IOL. . . . . . . . . . . . . . . . . . . . . . 113
H.Burkhard Dick, Mana Tehrani,
Chapter 6 Luis G.Vargas,Stephen D.McLeod
Correction ofKeratometric Astigmatism:
Incisional Surgery . . . . . . . . . . . . . . . . . . 49 Chapter 13
Louis D.Nichamin Sarfarazi Elliptical Accommodative
Intraocular Lens. . . . . . . . . . . . . . . . . . . . 123
Chapter 7 Faezeh Mona Sarfarazi
STAAR Toric IOL . . . . . . . . . . . . . . . . . . . 59
Stephen Bylsma
XI
Contributors
Jorge L.Alio,MD,PhD Richard S.Hoffman,MD
Inst Oftalmologico de Alicante Department ofOphthalmology
Avda Denia 111 Oregon Health & Science University
Alicante 03015,Spain 1550 Oak St.Suite 5
Eugene,Oregon 97401,USA
Rosa Braga-Mele,MD,FRCSC
200-245 Danforth Ave. Jack Holladay,MD
Toronto,Ontario M4K 1N2,Canada 5108 Braeburn Drive
Bellaire,TX 77401-4902,USA
Stephen S.Bylsma,MD
Shepherd Eye Center John Hunkeler,MD
1414 E Main Street Hunkeler Eye Institute,P.A.
Santa Maria,CA 93454,USA 4321 Washington,Suite 6000
Kansas City,MO 64111-5905,USA
Robert J.Cionni,MD
Cincinnati Eye Institute Douglas Koch,MD
10494 Montgomery Rd Cullen Eye Institute
Cincinnati,OH 45242,USA 6565 Fannin,Suite NC205
Houston,TX 77030,USA
Steven J.Dell,MD
1700 S Mopac Thomas Kohnen,MD
Austin,TX 78746-7572,USA Johann Wolfgang Goethe-University
Department ofOphthalmology
H.Burkhard Dick,MD,PhD Theodor-Stern Kai 7
Department ofOphthalmology 60590 Frankfurt,Germany
Johannes Gutenberg-University
Langenbeckstraße 1 Stephen S.Lane,MD
55131 Mainz,Germany Associated Eye Care,Ltd.
232 North Main Street
I.Howard Fine,MD Stillwater,MN 55082,USA
Department ofOphthalmology
Oregon Health & Science University Richard L.Lindstrom,MD
1550 Oak St.Suite 5 Minnesota Eye Consultants,P.A.
Eugene,Oregon 97401,USA 710 E.24th Street,Suite 106
Minneapolis,MN 55404,USA
