Journal - American Intra-Ocular Implant Society最新文献

A partially disposable coaxial system for manual extracapsular extraction is presented. This system provides for straight and curved irrigation/aspiration cannulas by means of a flexible outer sleeve. The elimination of a variety of connector tubings and nonluer-locked fittings has reduced intraoperative manipulations when compared to other partially disposable irrigation/aspiration systems.

We have modified our technique of subcapsular phacoemulsification and aspiration in two ways: (1) Intracapsular phacoemulsification is performed without an anterior capsulotomy. Because the inner wall of the anterior capsule can be cleaned completely by the irrigation/aspiration tip through a small opening in the anterior lens capsule, the clean capsular bag is retained. (2) An intraocular lens (IOL) is inserted completely into the bag. If desired, the central part of the anterior capsule can be removed before or after IOL implantation. We propose changing the name of this technique to intracapsular phacoemulsification and aspiration and complete in-the-bag IOL fixation.

Postoperative corneal astigmatism induced by implantation of an oversized rigid anterior chamber intraocular lens has been studied. Sources of error leading to the choice of an oversized lens as well as the mechanism by which an oversized lens induces corneal astigmatism are discussed.

Although extracapsular cataract extraction and posterior chamber lens technology is of unrivaled safety and efficacy, the following aspects command considerable attention: chronic postoperative inflammation, inhibition of posterior capsular opacification, facilitation of YAG-laser posterior capsulectomy, prevention of ultraviolet radiation exposure, and sulcus versus capsular-bag fixation of posterior chamber lenses. The differential diagnosis of lens-induced and intraocular-lens-induced inflammation is presented, along with recommendations for the treatment and management of the second eye. Use of the complete laser-ridge lens to create a barrier for migrating cells capable of causing posterior capsular opaciflcation is discussed. Using it to create a space between the posterior surface of the optic and the posterior capsule to facilitate YAG-laser posterior capsulectomy is also described. The status of ultraviolet blockers in intraocular lenses is discussed. The transition to capsular-bag fixation is recommended based on the following problems with sulcus-fixated lenses: mechanical disruption of the blood-aqueous barrier with release of inflammatory mediators, hemorrhage from or obstruction in the major arterial circle, the danger of polypropylene in metabolically active tissue, and the posterior iris chafing syndromes.

A BASIC program to calculate intraocular lens power and refractive errors using previously derived equations is presented. The program was written for the IBM PC and PCjr computers with an emphasis on clinical usefulness. Program features include a comparison of refractive and axial length predictions of secondary implant power and velocity compensation for axial length measurements made on aphakic patients. Equation specification by input variable selection and automatic averaging of keratometer readings make the program highly efficient.

A simple modification of the Kratz incision technique provided better astigmatism control in the immediate postoperative period without use of the surgical keratometer than the original technique.