Lensx Laser Cataract Surgery Implant
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Ethical, Legal and Psychosocial Aspects of Transplantation Global Challenges
E. K. Massey, F. Ambagtsheer, W. Weimar (Eds.) Ethical, Legal and Psychosocial Aspects of Transplantation Global Challenges PABST E. K. Massey, F. Ambagtsheer, W. Weimar (Eds.) Ethical, Legal and Psychosocial Aspects of Transplantation Global Challenges PABST SCIENCE PUBLISHERS Lengerich Bibliographic information published by Die Deutsche Nationalbibliothek Die Deutsche Nationalbibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data is available in the Internet at <http://dnb.ddb.de>. This work is subject to copyright. All rights are reserved, whether the whole or part of the mate- rial is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a spe- cific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The authors and the publisher of this volume have taken care that the information and recommen- dations contained herein are accurate and compatible with the standards generally accepted at the time of publication. Nevertheless, it is difficult to ensure that all the information given is entirely accurate for all circumstances. The publisher disclaims any liability, loss, or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this volume. © 2017 Pabst Science Publishers · D-49525 Lengerich Internet: www.pabst-publishers.de, www.pabst-science-publishers.com E-mail: [email protected] Print: ISBN 978-3-95853-292-2 eBook: ISBN 978-3-95853-293-9 (www.ciando.com) Formatting: µ Printed in Germany by KM-Druck, D-64823 Gross-Umstadt Contents Preface Introduction Emma K. -
Utah Eye Centers Now Offers the Latest Advance in Laser Eye Surgery
Mark G. Ballif, M.D. Scott O. Sykes, M.D. Michael B. Wilcox, M.D. John D. Armstrong, M.D. Robert W. Wing, M.D., FACS Keith Linford, O.D. Jed T. Poll, M.D. Claron D. Alldredge, M.D. Devin B. Farr, O.D. Michael L. Bullard, M.D. Court R. Wilkins, O.D. Utah Eye Centers Now Offers the Latest Advance In Laser Eye Surgery The New VICTUS® Femtosecond Laser Platform, from Bausch + Lomb is Designed to Support Positive Patient Experience and Outstanding Visual Results in Cataract and LASIK Procedures FOR RELEASE April 17, 2015 Ogden, Utah— Utah Eye Centers, the leading comprehensive ophthalmology practice in northern Utah, announced today the Mount Ogden facility now offers eye surgery for cataracts and LASIK with an advanced laser system, the VICTUS® femtosecond laser platform. They are the only practice north of Salt Lake City with a fixed site femtosecond laser for cataracts and LASIK. The versatile VICTUS platform is designed to provide greater precision compared to manual cataract and LASIK surgery techniques. According to Scott Sykes, M.D., the Victus laser is the only laser approved to perform treatments for both cataract and LASIK surgeries. "With the VICTUS platform, we are able to automate some of the steps that we have commonly performed manually," said Mark Ballif, M.D. "While we have performed thousands of successful cataract and LASIK surgeries, the VICTUS platform helps us to improve the procedures to give our patients the best outcomes possible." The VICTUS platform features a sophisticated, curved patient interface with computer-monitored pressure sensors designed to provide comfort during the procedure. -
Bilateral Same-Day Laser Peripheral Iridotomy in the Philadelphia Glaucoma Detection and Treatment Project
ORIGINAL STUDY Bilateral Same-day Laser Peripheral Iridotomy in the Philadelphia Glaucoma Detection and Treatment Project Michael Waisbourd, MD,* Anousheh Shafa, BS,* Radha Delvadia, BS,* Harjeet Sembhi, MPH,* Jeanne Molineaux, COA,* Jeffery Henderer, MD,w Laura T. Pizzi, PharmD, MPH,z Jonathan S. Myers, MD,* Lisa A. Hark, PhD, RD,* and L. Jay Katz, MD* reported in 2 patients (3%) and glare in 1 patient (1.5%). Thirteen Purpose: To report the outcomes of bilateral, same-day laser patients (19.7%) had repeat LPI treatment. All patients success- peripheral iridotomy (LPI) in the Philadelphia Glaucoma Detec- fully tolerated LPI treatment without serious complications. tion and Treatment Project. Conclusions: Performing bilateral, same-day LPI was well tolerated Methods: The Philadelphia Glaucoma Detection and Treatment in a large community-based, glaucoma detection and treatment Project was a community-based initiative aimed to improve project. Applying this treatment strategy may be considered in detection, management, treatment, and follow-up care of individ- similar settings, where patients’ access to eye care is limited and it uals at high risk for glaucoma. This novel project performed LPI, may be a cost-effective strategy. where 2 eyes received laser therapy on the same day. Of the 1649 patients examined between January 1, 2013 and May 31, 2014, Key Words: glaucoma detection, angle closure, laser peripheral patients who underwent bilateral, same-day LPI were included in iridotomy, bilateral same-day ocular procedures our analysis. Main outcome measures were visual acuity, intra- (J Glaucoma 2016;25:e821–e825) ocular pressure (IOP), and postoperative complication rates. Results: A total of 132 eyes of 66 patients underwent bilateral, aser iridotomy is aimed to eliminate the relative pupil- same-day LPI. -
Four Cases of Corneal Perforation in Patients with Chronic Graft- Versus-Host Disease
Molecular Vision 2011; 17:598-606 <http://www.molvis.org/molvis/v17/a68> © 2011 Molecular Vision Received 21 October 2010 | Accepted 15 February 2011 | Published 25 February 2011 Four cases of corneal perforation in patients with chronic graft- versus-host disease Emi Inagaki, Yoko Ogawa, Yukihiro Matsumoto, Tetsuya Kawakita, Shigeto Shimmura, Kazuo Tsubota Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan Purpose: To report the clinical features and investigate the underlying pathological processes of spontaneous corneal perforation in patients with ocular chronic graft-versus-host disease (cGVHD). Methods: A full ophthalmological evaluation of corneal perforation in four patients with cGVHD was performed. Three of them underwent deep anterior lamellar keratoplasty and samples from two of three patients were used for histopathological analyses. Results: Three patients were successfully treated by corneal transplantation. One patient was treated with a therapeutic soft contact lens, and the wound healed within 2 days. The common clinical features of these patients were (1) the presence of definite dry eye related to cGVHD in 3 of 4 patients and probable dry eye in one patient, (2) a central or paracentral site of corneal ulceration and perforation, with no sign of infection, and (3) prior use of a topical or systemic corticosteroid, and/or topical non-steroidal anti-inflammatory drugs. Immunohistochemical findings revealed an increased number of cluster of differentiation 68+ (CD68+) macrophages and matrix metalloproteinase 9 (MMP-9) expression in the tissue surrounding the perforation. Conclusions: Our report extends current information on the clinical features and pathological processes of corneal perforation in cGVHD by showing increased MMP-9 expression and the accumulation of CD68+ positive macrophages in the affected areas. -
Nd:YAG CAPS ULOTOMY AS a PRIMARY TREATMENT
PSEUDOPHAKIC MALIGNANT GLAUCOMA: Nd:YAG CAPS ULOTOMY AS A PRIMARY TREATMENT B. C. LITTLE and R. A. HITCHINGS London SUMMARY anisms of ciliolenticular block of aqueous flow leading to Malignant glaucoma is one of the most serious but rare the misdirection of aqueous posteriorly into or in front of complications of anterior segment surgery. It is best the vitreous gel leading to the characteristic diffuse shal known following trabeculectomy but has been reported lowing of the anterior chamber accompanied by a precipi following a wide variety of anterior segment procedures tous rise in intraocular pressure. The mechanistic including extracapsular cataract extraction with pos understanding of its pathogenesis has led to the use of the terior chamber lens implantation. It is notoriously refrac synonyms 'ciliolenticular block',7 'ciliovitreal block', tory to medical treatment alone and surgical intervention 'iridovitreal block',8 'aqueous misdirection' and 'aqueous has had only limited success. An additional treatment diversion syndrome'. Although probably more precise option in pseudophakic eyes is that of peripheral these are unlikely to succeed the original term 'malignant Nd:YAG posterior capsulotomy, which is minimally glaucoma', which more accurately evokes the fulminant invasive and can re-establish forward flow of posteriorly nature of the condition as well as the justified anxiety asso misdirected aqueous through into the drainage angle of ciated with it. Medical treatment alone is rarely successful the anterior chamber. We report our experience of seven in establishing control of the intraocular pressure.2•8 Pars cases of malignant glaucoma in pseudophakic eyes and of plana vitrectomy has been used in the surgical managment the successful use of Nd:YAG posterior capsulotomy in of malignant glaucoma with some definite but limited suc re-establishing pressure control in' five of these eyes, cess in phakic as well as pseudophakic eyes.9•10 thereby obviating the need for acute surgical However, when malignant glaucoma develops in intervention. -
Special Considerations in Cataract Surgery: Five Cornea Challenges
Clinical Update EXTRA CONTENT AVAILABLE CATARACT Special Considerations in Cataract Surgery: Five Cornea Challenges by linda roach, contributing writer interviewing preston h. blomquist, md, rosa a. braga-mele, md, kimberly a. drenser, md, phd, herbert e. kaufman, md, marguerite mcdonald, md, and roger f. steinert, md s the most common surgical choices, said Marguerite McDonald, IOL Selection procedure in ophthalmol- MD, of Lynbrook, N.Y. The device en- ogy, replacement of a cloudy ables the surgeon to directly measure 1 crystalline lens with an the eye’s aphakic refractive power in intraocular lens (IOL) usu- the operating room. Aally presents the ophthalmologist with Using intraoperative aberrometry is familiar sets of surgical routines. But becoming more commonplace, as “it what about those cases that involve may help in achieving more accuracy comorbidities or other complicating with IOL power selection,” Dr. Mc- factors? Donald said. Several experts shared their per- Tips on IOL selection. The chosen spectives on approaching out-of-the- IOL should be shaped to neutralize After an off-center LASIK procedure ordinary cataract surgeries in ways spherical aberrations, said Rosa A. such as this, the irregularity of the that offer the best chance at optimiz- Braga-Mele, MD, at the University of corneal topography indicates that a ing patient outcomes. This month, Toronto. “In anybody who has had multifocal IOL should be avoided. here’s a look at five challenges involv- myopic LASIK or PRK, I think it’s very ing the cornea. important to use a negatively aspheric prior to cataract surgery. 2) A dysfunc- IOL, because these patients have more tional, unstable tear film will affect the Challenge: Prior Refractive Surgery positively aberrant corneas. -
Outcome of Lens Aspiration and Intraocular Lens Implantation in Children Aged 5 Years and Under
540 Br J Ophthalmol 2001;85:540–542 Outcome of lens aspiration and intraocular lens implantation in children aged 5 years and under Lorraine Cassidy, Jugnoo Rahi, Ken Nischal, Isabelle Russell-Eggitt, David Taylor Abstract However, final refraction is variable, such that Aims—To determine the visual outcome emmetropia in adulthood cannot be guaran- and complications of lens aspiration with teed, as there are insuYcient long term studies. intraocular lens implantation in children There have been many reports of the visual aged 5 years and under. outcome and complications of posterior cham- Methods—The hospital notes of all chil- ber lens implantation in children.4–12 Most of dren aged 5 years and under, who had these have been based on older children, undergone lens aspiration with intraocu- secondary lens implants, a high number of lar lens implantation between January traumatic cataracts, and many have reported 1994 and September 1998, and for whom early outcome. We report visual outcome and follow up data of at least 1 year were avail- complications of primary IOL implantation at able, were reviewed. least 1 year after surgery, in children aged 5 Results—Of 50 children who underwent years and under, with mainly congenital or surgery, 45 were eligible based on the juvenile lens opacities. follow up criteria. 34 children had bilat- eral cataracts and, of these, 30 had surgery Methods on both eyes. Cataract was unilateral in 11 SUBJECTS cases; thus, 75 eyes of 45 children had sur- We reviewed the notes of all children aged 5 gery. Cataracts were congenital in 28 years and under, who had undergone lens aspi- cases, juvenile in 16, and traumatic in one ration with primary posterior chamber in- case. -
Fast Facts & Stats
FAST FACTS & STATS “Of all the senses, sight must be the most delightful.” ~ Helen Keller More sensory neurons are dedicated to vision than the other four senses combined, and giving the gift of sight – through cornea donation – can be life-giving and life-changing. But what does it really mean? “Eye donation” doesn’t mean the entire eye is transplanted; instead, only the cornea (the clear, dome-shaped surface that covers the front of the eye) is replaced, restoring sight for those with cornea-related blindness. The entire eye can be used for research and education, potentially helping untold thousands of people regain their sight as researchers gain new understanding of the cause and effects of eye conditions that lead to blindness. Historical facts: · The first human corneal transplant was performed in 1905 by Dr. Eduard Zirm in Olomouc, Czechoslovakia. · The first U.S. transplant was performed in New York City by Dr. R. Townley Paton in 1937. · The first eye bank – a non-profit organization that recovers, evaluates, prepares and distributes eyes donated for use in corneal transplantation, research and education – opened in 1944 in New York City. · The Eye Bank Association of America, established in 1961, is the oldest transplant association and was formed by a group of ophthalmologists and eye bankers. Statistics: · 50,930: Number of corneas provided for transplant in the U.S. in 2017, meeting 100% of U.S. demand. · 33,367: Number of corneas exported, helping restore sight worldwide. · 12 million: Corneal disease cases worldwide that result in blindness or visual impairment— and that could be reversed with cornea transplants. -
Laser Learning Lecture and Lab: YAG Caps, LPI, And
5/9/17 Overview Laser Learning Lecture and Lab: • Why we use lasers YAG caps, LPI, and SLT • YAG capsulotomy • Laser Peripheral Iridotomy (LPI or PI) Aaron McNulty, O.D., F.A.A.O. • Argon Laser Peripheral Iridoplasty (ALPI) Nate Lighthizer, O.D., F.A.A.O. • Argon Laser Trabeculoplasty (ALT) • Selective Laser Trabeculoplasty (SLT) • Other Laser Trabeculoplasty Why do we use lasers? Posterior Capsular Opacification (PCO) • Vision is decreased from PCO following cataract surgery • Lens capsular bag has an anterior and • Narrow angles/angle closure posterior surface • Glaucoma is progressing in a pt on max meds – Anterior surface usually removed w/ capsulorhexis – Something else needs to be done – Surgery not wanted yet • PCO is the formation of a cloudy membrane • Compliance issues on the posterior surface of the capsular bag • Cost issues following ECCE • Convenience issues – AKA: Secondary cataract • Doctor preference PCO YAG Laser • Incidence: • Nd: YAG laser – Most common complication of post ECCE – Neodymium: Yttrium aluminum garnet laser – 10-80% of eyes following cataract surgery – Can form anywhere from a few days to years post surgery • Tissue interaction: Photodisruptive laser – Younger patients higher risk of PCO – High light energy levels cause the tissues to be reduced – IOL’s to plasma, disintegrating the tissue • Silicone > acrylic – A large amount of energy is delivered into very small focal spots in a very brief duration of time • Prevention: • 4 nsec – – Capsulotomy during surgery No thermal reaction/No coagulation when bv’s are hit – Posterior capsular polishing – Pigment independent* 1 5/9/17 YAG Cap Risks, Complications, YAG Cap Pre-op Exam Contraindications • Visual acuity, glare testing, PAM/Heine lambda Contraindications Risks/complications – Vision 20/30 or worse 1. -
Exploring Vigilance Notification for Organs
NOTIFY - E xploring V igilanc E n otification for o rgans , t issu E s and c E lls NOTIFY Exploring VigilancE notification for organs, tissuEs and cElls A Global Consultation e 10,00 Organised by CNT with the co-sponsorship of WHO and the participation of the EU-funded SOHO V&S Project February 7-9, 2011 NOTIFY Exploring VigilancE notification for organs, tissuEs and cElls A Global Consultation Organised by CNT with the co-sponsorship of WHO and the participation of the EU-funded SOHO V&S Project February 7-9, 2011 Cover Bologna, piazza del Nettuno (photo © giulianax – Fotolia.com) © Testi Centro Nazionale Trapianti © 2011 EDITRICE COMPOSITORI Via Stalingrado 97/2 - 40128 Bologna Tel. 051/3540111 - Fax 051/327877 [email protected] www.editricecompositori.it ISBN 978-88-7794-758-1 Index Part A Bologna Consultation Report ............................................................................................................................................7 Part B Working Group Didactic Papers ......................................................................................................................................57 (i) The Transmission of Infections ..........................................................................................................................59 (ii) The Transmission of Malignancies ....................................................................................................................79 (iii) Adverse Outcomes Associated with Characteristics, Handling and Clinical Errors -
Xenotransplantation: Past, Present, and Future
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Curr Opin Manuscript Author Organ Transplant Manuscript Author . Author manuscript; available in PMC 2018 December 01. Published in final edited form as: Curr Opin Organ Transplant. 2017 December ; 22(6): 513–521. doi:10.1097/MOT.0000000000000463. XENOTRANSPLANTATION: PAST, PRESENT, AND FUTURE Burcin Ekser, MD, PhD1, Ping Li, PhD1, and David K.C. Cooper, MD, PhD2 1Division of Transplant Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA 2Xenotransplantation Program, Department of Surgery, The University of Alabama at Birmingham, Birmingham, AL, USA Abstract Purpose of review—To review the progress in the field of xenotransplantation with special attention to most recent encouraging findings which will eventually bring xenotransplantation to the clinic in the near future. Recent findings—Starting from early 2000, with the introduction of Gal-knockout pigs, prolonged survival especially in heart and kidney xenotransplantation was recorded. However, remaining antibody barriers to nonGal antigens continue to be the hurdle to overcome. The production of genetically-engineered pigs was difficult requiring prolonged time. However, advances in gene editing, such as zinc finger nucleases, transcription activator-like effector nucleases, and most recently CRISPR technology made the production of genetically-engineered pigs easier and available to more researchers. Today, the survival of pig-to-nonhuman primate heterotopic heart, kidney, and islet xenotransplantation reached >900 days, >400 days, and >600 day, respectively. The availability of multiple-gene pigs (5 or 6 genetic modifications) and/or newer costimulation blockade agents significantly contributed to this success. Now, the field is getting ready for clinical trials with an international consensus. -
History of Corneal Transplantation, Eye Banking and the EBAA The
History of Corneal Transplantation, Eye Banking and the EBAA The Success of Early Corneal Transplants In 1905, when Eduard Konrad Zirm, MD, performed the first successful corneal transplant, a long line of corneal transplantation, research and techniques began. During its existence, Zirm’s eye bank, located in a rural area of Austria, treated over 47,000 patients. Not many years later in 1914, Anton Elschnig, MD, also of Austria, performed the second successful corneal transplant and over the next two decades, he would make various contributions to the study of peri-operative infection and pre-operative preparation. The 1920s and 1930s would find Russian ophthalmologist Vladimir Filatov refining lamellar keratoplasty and developing a new method for full thickness keratoplasty. He also used a donor cornea from a cadaver for a penetrating keratoplasty in the 1930s. Ramon Castroviejo, a Spanish ophthalmologist, was an influential figure in both European and American developments in corneal transplantation, particularly from the 1920s through the 1940s. During his research fellowship at the Mayo Clinic, he developed a double-bladed knife for square grafts and conducted research that culminated in the development of new keratoplasty techniques. The Beginnings of Eye Banking and the EBAA The 1940s not only brought improvements to corneal transplantation, but also an incentive to mainstream those procedures into eye banking. R. Townley Paton, a renowned American ophthalmologist who was trained at Johns Hopkins in Baltimore, had established his own practice and had become affiliated with Manhattan Eye, Ear & Throat Hospital, where he began performing corneal transplants with privately-acquired tissue. After performing many corneal transplants, Paton came to the conclusion that a formal system of eye collection needed to be developed – thus, the eye bank was born.