DOCSLIB.ORG

Femtosecond Laser Cataract Surgery Zoltan Z

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Femtosecond Laser Cataract Surgery Zoltan Z Nagy and McAlinden Eye and Vision (2015) 2:11 DOI 10.1186/s40662-015-0021-7 REVIEW Open Access Femtosecond laser cataract surgery Zoltan Z. Nagy1* and Colm McAlinden2,3 Abstract Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages have resulted in improved visual and refractive outcomes in the short term. Complication rates are low which reduce with surgeon experience. This review article focuses on the Alcon LenSx system. Keywords: Femtosecond, Cataract surgery, Femtosecond laser, Capsulorhexis, Phacoemulsification, Corneal incisions, Corneal oedema, Macular oedema Introduction However, the Nd:YAG laser causes collateral damage Ophthalmology has always been at the forefront in the use and is the reason why it is not used in corneal proce- of lasers (Light Amplification by Stimulated Emission of dures. However, by shortening the wavelength further to − Radiation) and a variety of lasers have been employed for the femtosecond range (10 15), there is a reduction in more than 50 years [1–3]. In 1949, German ophthalmolo- acoustic shock waves that in turn results in markedly gist Dr. Gerhard Meyer-Schwickerath suggested photo- less collateral damage. This also results in a more precise coagulation of the retina with lasers [4]. A laser is a device tissue effect [9, 10]. that emits electromagnetic light via stimulated emission. The femtosecond laser (FSL) first appeared in corneal Ophthalmic lasers operate at one specific fixed wave- refractive surgery as a microkeratome to create the length, pulse pattern, energy, duration, repetition rate, and corneal flap during laser in situ keratomileusis (LASIK) spot size. This enables photons in phase from the coher- [11]. Thereafter the indication has expanded to all types ent, monochromatic laser beam to arrive at the same time of corneal surgery including lamellar and penetrating and place in the target tissue. Hence, by modifying these keratoplasty, ring-segment implantation in keratoconus parameters they may be absorbed in various tissues at and presbyopia inlay pocket creation [12, 13]. The first various depths with varying biological effects. This has corneal FSLs operated with 30 kilohertz, (kHz)). The resulted in lasers being able to target any issue within the repetition rate was then doubled to 60 kHz and the lat- eye. Many lasers operate by molecular vibration, which est 160 kHz FSLs are able to create a corneal flap within causes localized thermal effects such as photocoagulation 10 s. With higher repetition rates, less energy is required (e.g. argon laser) [5] resulting in protein denaturation. to obtain the same tissue effect. FSLs used in cataract Other lasers operate by photoablation such as the excimer surgery employ a pulse duration of 400–800 femtoseconds − laser used in refractive surgery [6, 7] and by photodisrup- (fs) and the energy range is in microjoules (μJ, 10 6 J). tion such as the neodymium: yttrium-aluminium-garent During the surgery of the crystalline lens of the eye, the (Nd:YAG) laser [8] (Fig. 1). FSL energy may be increased to 10–15 μJ (Fig. 2). The Nd:YAG laser has a pulse duration in the nano- The photodisruptive effect is achieved when the FSL − second range (10 9) and causes photodisruption at its beam is sharply focused and generates plasma within the focal point, such as the posterior capsule of the lens. affected tissue. This plasma rapidly expands as an acous- tic shock wave, displacing the surrounding tissue. With time, the plasma cools and cavitation bubbles are * Correspondence: [email protected] formed. At tissue level, photodisruption occurs at the la- 1Department of Ophthalmology, Semmelweis University, Maria u. 39, H-1085 Budapest, Hungary ser’s focal point without any thermal effect or collateral Full list of author information is available at the end of the article © 2015 Nagy and McAlinden. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Nagy and McAlinden Eye and Vision (2015) 2:11 Page 2 of 8 Argon Diode Nd:Glass Er:Yag CO2 457-514 nm 805-820 nm 1053 nm 2940 nm 10,600 nm 193 nm 100 nm 400 nm 700 nm 100,000 nm EXCIMER FS Lasers Ultraviolet Visible Infrared Fig. 1 Lasers in ophthalmology; excimer lasers operate in the ultraviolet range whereas femtosecond lasers operate in the infrared range of the electromagnetic spectrum tissue damage [14]. With this photodisruptive effect, the The accuracy of corneal laser refractive surgery is sig- FSL is capable of creating tissue separation and very pre- nificantly higher than in cataract surgery [19], therefore cise cuts within the cornea, lens capsule and crystalline much work is needed to improve refractive outcomes. lens. Patient expectation has risen and doctors need to be One of the most important characteristics of the FSL proficient at communicating with patients to manage ex- during corneal and lens use is the numerical aperture. pectations accordingly [20]. FSLs offer new potential for The numerical aperture significantly affects both the patients and surgeons alike. spot size and volume. With a larger numerical aperture, less dispersion of the laser beam ensues that in turn pro- Review vides a better focused laser beam. Further, the precision Technical aspects of FSLs of the cut depth improves and lower energy is needed to The Alcon LenSx FSL operates with a solid state laser provide the same tissue effect. Therefore, corneal treat- source that produces thousands of fs pulses per second ments require a larger numerical aperture (with a lower (Fig. 3). The laser pulses are delivered via a sophisticated energy level), and vice versa with the crystalline lens. It beam delivery system. This system includes an arti- is important that a FSL treating both the cornea and the culated arm, a series of optical lenses, scanners and crystalline lens simultaneously should have adequate monitors. The Alcon LenSx laser system is capable of flexibility in the energy, pattern and duration of the providing a variable numerical aperture for optimal pulse as well as the repetition rate [15]. performance in both the corneal and lens plane [15]. Cataract surgery is the most commonly performed The first part of FSL assisted cataract surgery with the ophthalmic procedure worldwide [16, 17]. Cataract sur- Alcon LenSx is the docking procedure. The surgeon uses gery has shifted its focus from a purely vision restoration a curved contact lens, which is integrated with a sterile procedure to a refractive procedure. Ophthalmic sur- limbal suction ring (SoftFit PI). The tubing uses a vac- geons not only restore clarity of the optical media, but uum system to fixate the eye. The patient interface is also change the refractive power of the eye. Further, simple to dock and it provides a large viewing and surgi- presbyopic treatment is now possible with the use of cal diameter range that allows the surgeon to perform multifocal intraocular lenses (IOLs) [18]. the peripheral corneal incisions and arcuate keratotomy incisions. The patient interface is associated with eleva- tions in intraocular pressure (IOP) of between 16 and 20 mmHg, which supports conservation of vision and Excimer laser Femtosecond laser ocular perfusion during the FSL pretreatment [21]. The Alcon LenSx system has a built-in high definition optical coherence tomography (OCT) system and a live video to assist with the docking and surgical pattern localization (Fig. 4). The OCT uses the same optical path as the laser beam and is fully integrated and calibrated. Precise superficial Precise deeper effect The OCT covers the complete anterior segment of the effect eye up to the posterior capsule of the crystalline lens. It Fig. 2 Corneal surgery based on photodisruption. Excimer lasers is also capable of assessing the lens density. The LenSx produce precise superficial effects whereas femtosecond lasers produce automatically performs the surgical pattern after pre- precise deeper effects within the cornea and the crystalline lens operative planning by the surgeon and the selection of Nagy and McAlinden Eye and Vision (2015) 2:11 Page 3 of 8 Monitor for the anterior segment Patient interface Fig. 3 The LenSx femtosecond laser settings. The surgeon is able to alter the various treat- Semmelweis University in Budapest, Hungary [22]. Since ment parameters, such as the corneal incision positions, then the United States Food and Drug Administration centration of the anterior capsulotomy, and cut depth (FDA) has granted approval and the European Confor- within the crystalline lens. mité Européene (CE) mark has been granted for FSLs, With the new software version and coupling by the and FSLs are available for the public. There are currently Verion pre-operative assessment system, conjunctival, four international companies producing and providing scleral vessels and iris characteristics are identified and this new technology for cataract surgery. Peer-reviewed recognised. This provides automated recognition and publications are increasing on the subject and it is pre- centration of the procedure. dicted that within a decade, the method will be available The first human FSL assisted cataract surgery was per- in most of the large ophthalmic centres around the formed with the Alcon LenSx in 2008 by Zoltan Nagy at world [23]. Capsulotomy Lens fragmentation Anterior capsule cut Lens fragmentation area Positioning the corneal incisions Fig.
Load more

Recommended publications
  • Early Postoperative Rotational Stability and Its Related Factors of a Single-Piece Acrylic Toric Intraocular Lens
    Eye (2020) 34:474–479 https://doi.org/10.1038/s41433-019-0521-0 ARTICLE Early Postoperative Rotational stability and its related factors of a single-piece acrylic toric intraocular lens 1,2 3 4 5 1 1 1 Shuyi Li ● Xi Li ● Suhong He ● Qianyin Zheng ● Xiang Chen ● Xingdi Wu ● Wen Xu Received: 30 November 2018 / Accepted: 18 June 2019 / Published online: 12 July 2019 © The Author(s) 2019. This article is published with open access Abstract Purpose In the present study, we aimed to evaluate the early postoperative rotational stability of TECNIS toric intraocular lens (IOL) and analyse its correlation with preoperative and intraoperative parameters. Methods A total of 102 eyes from 87 cataract patients who underwent implantation of TECNIS toric IOL during July 2016 to November 2017 were enrolled in this retrospective study. Preoperative parameters including corneal astigmatism, axial length (AL), lens thickness (LT), anterior chamber depth (ACD) and sulcus-to-sulcus (STS), were determined. The area of capsulorhexis was measured with Rhinoceros 5.0 software. The follow-up examinations including the residual astigmatism (RAS) and postoperative toric IOL axis, were performed at 1 month and 3 months after surgery. − − 1234567890();,: 1234567890();,: Results RAS was 0.84 ± 0.88 D at 1 month and 0.81 ± 0.89 D at 3 months after surgery. The rotation of toric IOL at 3 months was 4.83 ± 3.65°. The Pearson’s r of ACD, horizontal and vertical STS, and toric IOL target axis was 0.011, 0.039, 0.045 and 0.082. The toric IOL rotation was positively correlated with the area of capsulorhexis (r = 0.522, P = 0.0003), LT (r = 0.288, P = 0.003) and AL (r = 0.259, P = 0.009).
    [Show full text]
  • Nd:Y AG LASER CLEARANCE of the ANTERIOR SURFACE of POSTERIOR CHAMBER INTRAOCULAR LENSES
    Nd:Y AG LASER CLEARANCE OF THE ANTERIOR SURFACE OF POSTERIOR CHAMBER INTRAOCULAR LENSES S. J. TALKS Northampton SUMMARY CASE REPORTS Purpose: To demonstrate the use of Nd:YAG laser in Case 1. Post-operative Haemorrhage clearing the anterior surface of posterior chamber A 73-year-old Caucasian insulin-dependent diabetic intraocular lenses. man, on aspirin, who had previously had a right Method: Six cases are presented with the following trabeculectomy, had a right extracapsular cataract conditions: haemorrhage, inflammatory deposits, a extraction (ECCE) + pcIOL. At surgery a broad fibrinous papillary membrane, capsulorhexis shrinkage. iridectomy was performed through the original Nd:YAG laser was successful in managing Results: peripheral iridectomy to enable adequate pupil each of these cases. dilation. This was sutured with 10.0 Prolene. No Conclusion: With careful use Nd:YAG laser clearance haemorrhage was noted during surgery but the next of the anterior surface of a posterior chamber day a large blood clot covered the pupil. This did not intraocular lens can be carried out successfully without clear with the use of prednisolone acetate 1 % damaging the lens. (Predforte) and mydriatics. The patient did not wish further surgery. Following cataract surgery the anterior surface of After 3 months the visual acuity was still hand posterior chamber intraocular lenses (pcIOL) can movements and so Nd:YAG laser was used. The sometimes become obscured.1 This may be due to laser was applied to the organised clot at the edge of haemorrhage, inflammatory deposits, the formation the pupil (171 pulses, at 2-3 mJ, Q switched). Most of of a fibrinous pupillary membrane, or the shrinkage the clot cleared leaving a fibrinous membrane.
    [Show full text]
  • Little Capsulorhexis Tear-Out Rescue
    J CATARACT REFRACT SURG - VOL 32, SEPTEMBER 2006 Little capsulorhexis tear-out rescue Brian C. Little, FRCOphth, Jennifer H. Smith, MD, Mark Packer, MD Backward traction on the capsule flap forms the basis of a predictable technique for rescuing the capsulorhexis from a radial tear-out. J Cataract Refract Surg 2006; 32:1420–1422 Q 2006 ASCRS and ESCRS The continuous curvilinear capsulorhexis (CCC) has pro- and in the direction of the projected circular path of the fin- vided important advantages for lens removal and intraocu- ished capsulorhexis. In the event of a tear-out, the path of lar lens (IOL) implantation by prompting the development the progressing tear veers peripherally toward the lens of endocapsular phacofragmentation techniques and the equator. To ‘‘rescue’’ the capsulorhexis, the tear must be re- use of advanced IOL technology. Ophthalmologists have directed centrally and back to the desired circumferential benefited from the work of Fercho, who developed contin- path. The first step in rescuing the tear with the Little tech- uous tear capsulotomy (C. Fercho, MD, ‘‘Continuous Cir- nique is to fill the chamber completely with an OVD. The cular Tear Anterior Capsulotomy,’’ presented at the Welsh force applied to the capsule flap is then reversed in direc- Cataract Congress, Houston, Texas, USA, September tion but maintained in the plane of the anterior capsule. 1986), and Gimbel and Neuhann, who popularized the If necessary, a second corneal paracentesis incision is CCC.1–3 made at the position that allows the optimum angle of ap- In constructing the capsulorhexis, it is essential to con- proach for applying traction.
    [Show full text]
  • History of Posterior Continuous Curvilinear Capsulorhexis and Optic
    HISTORY OF POSTERIOR CONTINUOUS CURVILINEAR BY HOWARD V. GIMBEL, MD, MPH, FRCSC CAPSULORHEXIS AND OPTIC CAPTURE This useful technique is not just for pediatric surgery. econdary cataracts after pedi- I first used this technique in 1987 children in a publication coauthored atric cataract surgery have long to remove a dense posterior capsular with DeBroff in 1994.4 been recognized as an expected plaque and in 1988 to convert a PC In my early experience, the PCCC complication when the posterior tear to a PCCC.2 was done after the IOL was in the bag capsule is left intact. Planned Optic capture in the anterior con- so that, in the event of an unsuccess- Santerior vitrectomy after posterior tinuous curvilinear capsulorhexis was ful PCCC, the IOL would already be capsulectomy or capsulotomy is now described by Neuhann and Neuhann safely in the bag. To keep the vitreous performed routinely with cataract and in a film, “The Rhexis-Fixated Lens,” from coming through the PCCC as it IOL surgery in children. This is because, in 1991.3 With the experience I was being fashioned, a highly cohesive even with the posterior capsule open gained using that technique in adult OVD was placed through the first and the IOL in the bag, lens epithelial cataract surgery, it seemed obvious small tear in the PC. Then more OVD cell migration can proceed through that, after performing a PCCC, the was added as the tear was completed the posterior continuous curvilinear same capture technique could be with forceps. Optic capture was then capsulorhexis (PCCC), behind the IOL, used with the haptics left in the bag performed slowly, one edge at a time, and across the visual axis, making it and the optic captured by the PCCC.
    [Show full text]
  • Tips and Techniques for Cataract Surgery in Glaucoma Patients
    Tips and Techniques for Cataract Surgery in Glaucoma Patients Joey Yen-Cheng Hsia, MD Assistant Professor of Ophthalmology Glaucoma Service University of California, San Francisco No Financial Disclosures Introduction • Visually significant cataract often co-exist with glaucoma in the elderly population. • Glaucoma incisional surgery can lead to accelerated cataract formation. • Glaucoma patients are at risk for perioperative complications • Set realistic expectation preoperatively Preoperative Evaluation – Is the cataract or glaucoma causing the decreased vision? – PAP or PAM – Set realistic expectation – Is the IOP at target? – Role of combined surgery? – No. of medications – Anticoagulation – ⍺-1 blocker – Prior incisional surgeries Examination – angle grading, trab ostium - Prior incisional surgery - endothelial dysfunction – shallowing – dilation, prior LPI, iridectomy – PXE, phacodynesis – cupping, pallor, retinal pathology Postoperative IOP Spike • Note the of glaucoma – Foveal involving scotoma – At risk for progression with IOP spike : – Advanced glaucoma, IFIS, No. of gtts, long AXL, PXE • IOP spike occurs after surgery – Same day check up for high risk patients History of Trabeculectomy – Modify incisions accordingly – Avoid suction / fixation ring – High function bleb may lead to chemosis / chamber instability – Age<50, Preop IOP > 10, iris manipulation, postop IOP spike, and short interval time between trabeculectomy and cataract – Longer steroid +/- anti- metabolite Grover-Fellman spatula; Epislon History of Tube Shunt –
    [Show full text]
  • Collecting Empirical Physician Time Data
    H EA LTH POLI CY CEN TER RESEARCH REPORT Collecting Empirical Physician Time Dat a Piloting an Approach for Validating Work Relative Value Units St ephen Zuckerman, PhD Kat ie Merrell, BA Robert Berenson, MD Susan Mitchell, RHIA URBAN INSTITUTE ACTUARIAL RESEARCH URBAN INSTITUTE RTI INTERNATIONAL CORPORATION (FORM ERLY SOCIAL & SCIENTIFIC SYSTEM S, I N C.) Divvy Upadhyay, MD, MPH Rebecca Lewis, MPH URBAN INSTITUTE RTI INTERNATIONAL December 2016 ABOUT THE URBAN INSTITUTE The nonprofit Urban Institute is dedicat ed to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Copyright © December 2016. Urban Institute. Permission is granted for reproduction of this file, with attribution to the Urban Institute. Cover image by Tim M eko. Contents Acknowledgments v Execut ive Summary vi Background 1 Collecting Empirical Service Time Dat a 3 Analytic Approach and Methods 6 Preparing t he Empirical Time Data for Analysis 6 Empirical Measure of Intraservice Physician Time 6 Clinical Expert Review Met hods 10 Physician Int erviews 13 Result s 15 Empirical Time Analysis 15 Empirical Time Estimates for Selected Services 15 Implications for Physician Work Values 21 Clinical Expert Review Results 29 Representativeness of Vignettes 29 Accuracy of Service Descriptions 30 Intraservice Time Estimates 34 Limitat ions: Challenges of Empirical Time Data Collection 36 Summary 38 Recommendations for Further Data Collection 39 Appendix A.
    [Show full text]
  • Type of Article
    Original Research Article Comparison between a modified three bend cystitome and conventional two bend cystitome in performing capsulorhexis A Nayak1*, P Bharathi2, P Santosh3, A Shetty4 1,2,4Resident, Department of Ophthalmology, KIMS, Bangalore, INDIA. 3Comprehensive Fellow, Aravind Eye Hospital, 64, Sankagiri Main Road, Nethimedu, Salem. Email: [email protected] Abstract Aim: To evaluate the efficacy of a modified 3-bend cystitome compared with conventional 2-bend cystitome in performing continuous curvilinear capsulorhexis(CCC). Materials and Methods: We modified a 2-bend cystitome for CCC for Manual Small Incision Cataract Surgery and phacoemulsification surgery for improved safety and easier surgery. A 26G needle was converted into a cystitome with 3 bends. In our study, the performance of modified 3-bend cystitome was compared with a 2-bend cystitome. 162 eyes of 126 patients were included in our study. Results: In the 3- bend cystitome group, mean completion time of CCC and the viscoelastics used were less with the CCC success rate being higher. Complications like postoperative corneal edema and V-shaped tears, were also lower in 3-bend group. No posterior capsular rents or any other complication was observed in either group. Conclusion: It is safe, efficient and the 3 bend cystitome helps achieve a CCC while maintaining the anterior chamber depth (ACD) by keeping the posterior lip intact. The 3-bend cystitome allowed for adequate visualisation into the anterior chamber from a lack of wound deformation. Key Words: Capsulorhexis, Cataract, Cystitome, Phacoemulsification, SICS *Address for Correspondence: Dr. A. Nayak, Resident, Department of Ophthalmology, KIMS, Bangalore, INDIA. Email: [email protected] Received Date: 01/04/2019 Revised Date: 24/05/2019 Accepted Date: 11/07/2019 DOI: https://doi.org/10.26611/10091114 for a continuous curvilinear capsulorhexis (CCC), even Access this article online though femtosecond laser produced capsulotomies are Quick Response Code: more precise, accurate, reproducible, and stronger.
    [Show full text]
  • Efficacy of Plasma Knife Assisted Posterior Capsulotomy Versus
    Prakash S, Giridhar, Harshila Jain. Efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in preventing visual axis opacification in pediatric cataract surgery: A randomized controlled trial. IAIM, 2017; 4(9): 171-177. Original Research Article Efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in preventing visual axis opacification in pediatric cataract surgery: A randomized controlled trial Prakash S1*, Giridhar2, Harshila Jain3 1Assistant Professor, 2Professor and Head, 3Associate Professor Department of Ophthalmology, Dhanalakshmi Srinivasan Medical College and Hospital, Siruvachur, Perambalur, India *Corresponding author email: [email protected] International Archives of Integrated Medicine, Vol. 4, Issue 9, September, 2017. Copy right © 2017, IAIM, All Rights Reserved. Available online at http://iaimjournal.com/ ISSN: 2394-0026 (P) ISSN: 2394-0034 (O) Received on: 04-09-2017 Accepted on: 13-09-2017 Source of support: Nil Conflict of interest: None declared. How to cite this article: Prakash S, Giridhar, Harshila Jain. Efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in preventing visual axis opacification in pediatric cataract surgery: A randomized controlled trial. IAIM, 2017; 4(9): 171-177. Abstract Background: Posterior capsule opacification (PCO) is the commonest complication of extracapsular catraract surgery in pediatric patients with an incidence as high as 95%. But there is inadequate evidence on appropriate intervention to prevent PCO. Aim: To compare the efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in Pediatric Cataract surgery. Materials and methods: The current study was a randomized open labeled controlled study, conducted in the department of ophthalmology, All India Institute of Medical Sciences, New Delhi between July 2015 to June 2016.
    [Show full text]
  • Existing Posterior Capsular Defect (PPCD)
    Images in… BMJ Case Rep: first published as 10.1136/bcr-2021-243330 on 10 May 2021. Downloaded from Modified technique of managing congenital cataract with pre- existing posterior capsular defect (PPCD) Sudarshan Khokhar,1 Mousumi Banerjee ,1,2 Sanketh Singh Rathod,2 Sushil Kumar2 1Ophthalmology, All India DESCRIPTION Institute of Medical Sciences, Congenital cataract with pre- existing posterior New Delhi, Delhi, India 2 capsule defect (PPCD) is a rare condition with an RPC, All India Institute of incidence ranging from 2% to 6.7%.1 2 The most Medical Sciences, New Delhi, common hypothesis of PPCD is the presence of Delhi, India pre-existing posterior lenticonus and its subsequent Correspondence to thinning which leads to microleaks and rapid matu- Dr Mousumi Banerjee; ration of the cataract leading to further thinning banerjeemou12@ gmail. com and formation of posterior capsular defect.2 Surgical management in paediatric cataract with Accepted 22 April 2021 PPCD remains a challenge due to the increased risk of lens matter drop in the vitreous cavity. We present a modified approach of managing such challenging situations with preoperative ultrasound Figure 2 Clinical picture of type 2 posterior capsule biomicroscopy (UBM) and ‘dry lens aspiration tech- defect (PCD) in a 8- month- old chid with significant loss nique’ through limbal route . of lens volume (A) better appreciated after lens aspiration Three types of PPCD have been described in with circular, regular margins of type 2 PCD (B) clinical literature based on the morphology of the poste- picture of type 1 PCD in a 9- month- old child with nuclear rior capsular defect.
    [Show full text]
  • The Following Acronyms and Terms Have Been Compiled Through Input from the ARVO Membership and Are Presented Here for Your Reference
    # A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Search The following acronyms and terms have been compiled through input from the ARVO membership and are presented here for your reference. The acronyms may have additional meanings based on the context in which they are used. ARVO encourages the use of full terms when appropriate. Abbreviations and acronyms should be used on a limited basis and always defined with the first mention. ARVO is making this document available under the Creative Commons Attribution-NonCommercial license (CC BY-NC). You are free to copy and distribute the content with attribution for non-commercial purposes. Send any comments or questions to us via our online feedback form. Acronym Term Acronym Term 1D4 the last 8 amino acids of rhodopsin Add adduction, turn in, addition epitope (antigen sequence for 1d4 ADP adenosine diphosphate antibody) 2AFC two-alternative-forced-choice adRP autosomal dominant retinitis pigmentosa 5-FU 5-fluorouracil AFM atomic force microscopy AACG acute angle closure glaucoma Ag antigen AAV adenoassociated virus AGFX air gas fluid exchange Abd abduction (aka turn out) AGI Audacious Goals Initiative National ABK aphakic bullous keratopathy Eye Institute AC, A/C adenylate cyclase AGM anti-glaucoma medication AC Allen cards AGV Ahmed-glaucoma valve AC amacrine cell AH aqueous humor AC anterior chamber AHD aqueous humor dynamics AC/A accommodative AIDS acquired immune deficiency convergence/accommodation ratio syndrome ACA anterior chamber angle AIOL, accommodating intraocular lens aIOL
    [Show full text]
  • Changes in Blood Flow on Optic Nerve Head After Vitrectomy for Rhegmatogenous Retinal Detachment
    Retina Changes in Blood Flow on Optic Nerve Head After Vitrectomy for Rhegmatogenous Retinal Detachment Takeshi Iwase, Misato Kobayashi, Kentaro Yamamoto, Kosei Yanagida, Eimei Ra, and Hiroko Terasaki Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan Correspondence: Takeshi Iwase, De- PURPOSE. To determine the preoperative characteristics and the changes in retinal blood flow partment of Ophthalmology, Nagoya following vitrectomy in eyes with a rhegmatogenous retinal detachment (RRD). University Graduate School of Medi- cine, 65 Tsurumai-cho, Showa-ku, METHODS. Twenty-five–gauge vitrectomy without scleral bucking was performed on 31 eyes of Nagoya 466-8560, Japan; 31 patients with macula-on RRD. The retinal blood flow on the optic nerve head (ONH) was [email protected]. assessed by laser speckle flowgraphy (LSFG), and the mean blur rate (MBR) and pulse Submitted: August 21, 2016 waveform parameters before and at 10 days, 1, 2, 3, and 6 months after the surgery were Accepted: October 10, 2016 examined. Eyes treated by scleral buckling, and eyes with an epiretinal membrane and cataract that underwent surgery were used as controls. Citation: Iwase T, Kobayashi M, Ya- mamoto K, Yanagida K, Ra E, Terasaki RESULTS. The mean preoperative MBR-vessel on the ONH was significantly lower in eyes with H. Changes in blood flow on optic RRD than in the fellow unaffected eyes (P < 0.001), but it was not significantly different from nerve head after vitrectomy for rheg- the operated eye and the fellow eye in the control group. A significant increase in the mean matogenous retinal detachment.
    [Show full text]
  • Clinical Outcomes of Primary Posterior Continuous Curvilinear Capsulorhexis in Postvitrectomy Cataract Eyes
    Hindawi Journal of Ophthalmology Volume 2020, Article ID 6287274, 7 pages https://doi.org/10.1155/2020/6287274 Research Article Clinical Outcomes of Primary Posterior Continuous Curvilinear Capsulorhexis in Postvitrectomy Cataract Eyes Mengting Yu ,1 Duan Yan,1,2 Wenjie Wu ,1,2 Yingbin Wang,1 and Xinna Wu1 1Ophthalmology Department, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, China 2Ophthalmology Department, Fujian Provincial Hospital, Fuzhou 350001, China Correspondence should be addressed to Wenjie Wu; [email protected] Received 6 April 2020; Revised 11 June 2020; Accepted 14 July 2020; Published 31 July 2020 Academic Editor: Dirk Sandner Copyright © 2020 Mengting Yu et al. .is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To evaluate the safety and outcomes of primary posterior continuous curvilinear capsulorhexis (PPCCC) combined with phacoemulsification in postvitrectomy eyes. Design. Retrospective case series. Methods. Twenty-one postvitrectomy eyes of 21 patients with cataract between April 2017 and December 2019 were enrolled. PPCCC through the cornea incision was performed before in-the-bag intraocular lens implantation. All patients were followed up for at least 3 months postoperatively. .e outcome measures were corrected distance visual acuity (CDVA), intraocular pressure (IOP), corneal endothelium cell counts (CECC), central macular thickness (CMT), the occurrence of intraoperative or postoperative complications, and the incidence of posterior capsular opacification (PCO). Results. .e mean age was 56.14 ± 9.76 years (ranging from 31 to 68). .e mean Snellen CDVA was 20/400 preoperatively and improved to 20/67 postoperatively (P < 0:001).
    [Show full text]