Mastering Intraocular Lenses (IOLs) (Principles, Techniques and Innovations) Ashok Garg, JT Lin
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1Mastering Intraocular Lenses (IOLs) (Principles, Techniques and Innovations)
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3Mastering Intraocular Lenses (IOLs) (Principles, Techniques and Innovations)
Editors Ashok Garg MS, PhD, FIAO (Bel) FRSM, ADM, FAIMS, FICA International and National Gold Medalist Chairman and Medical Director, Garg Eye Institute and Research Centre, 235-Model Town, Dabra Chowk, Hisar- 125005 (India) JT Lin PhD Technical Director, New Vision, Inc. 4532, Old Carriage Trail, Oviedo, FL 32765 (USA) Guest Editors • I Howard Fine • Jorge L Alio • Georges Baikoff • Jerome Jean Bovet • Hiroshi Tsuneoka • Cyres K Mehta Foreword Richard Packard
4Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
B-3 EMCA House, 23/23B Ansari Road, Daryaganj
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Mastering Intraocular Lenses (IOLs) (Principles, Techniques and Innovations)
© 2007, Ashok Garg
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
This book has been published in good faith that the material provided by editors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2007
9788180619502
Typeset at JPBMP typesetting unit
Printed at Ajanta
5Dedicated to
Ashok Garg
JT Lin
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7Contributors 13Foreword
It is now over 56 years since Harold Ridley first implanted an intraocular lens to change ophthalmology forever. Over these years there have been extraordinary advances in lens design, material and range of function. In the first decade of this new century we can now offer our patients lenses not just for aphakia. As is made apparent in this book, lenses are available to correct virtually every optical defect of the eye. At the beginning we are led through the history of IOLs both phakic and pseudophakic. We are told how to measure the lens power with classical and new formulae and also how to do this in patients that have had refractive surgery, an increasingly important problem.
As we move forward to an era of smaller and smaller incisions for lens surgery new types of IOLs and insertion techniques are needed; all this is to be found in these pages. Further, interesting ideas like light adjustable lenses are put into context by, as with all of this book, recognised experts in the field.
Increasingly as accommodative and pseudo-accommodative lenses are developed the demand for refractive lens exchange will increase. There are many issues that surround this, not the least being which type of lenses are available and their various merits. The role of toric lenses for both aphakia and also in the phakic eye are highlighted.
As with all surgical endeavours, complications will occur. Early recognition and planned management will mitigate harm to our patients. There are chapters here to help us all when things go wrong.
In the final section, the changes in optic design to enhance contrast sensitivity and improve the quality of the image are discussed as well as new directions for IOLs.
I congratulate the editors Dr Ashok Garg, Dr JT Lin and all the contributors for giving us such a comprehensive account of IOLs of every description in this book.
Richard Packard
md do frcs frcophth
Clinical Director
Prince Charles Unit
King Edward VII Hospital
Windsor UK
Ph.: +44-175-382-9204
E-mail: mail@eyequack.vossnet.co.uk
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15Preface
Cataract Surgery has come of age specially in last two decades. From a moderate ICCE to ECCE, Phacoemulsification and now to Microphaco with IOL insertion this journey is truly mind blowing. Today the aim of Cataract Surgery and IOL Implantation is the restoration of functional vision. Which in practical terms is the ability of an individual to perform his daily living activities comfortably. Today is an era of Catarefractive Surgery. Refractive Lens Exchange was born from the realization that a segment of the population experiences visual disability imposed by their refractive status. These individuals as well as those with cataracts should enjoy the benefit of improved functional vision. The introduction and adoption of multifocal and accommodative IOLs is a natural extension of this belief.
Like cataract surgery Intraocular lenses (IOLs) have also made rapid strides in last two decades. From simple IOLs, two decade-back now a wide array of vision correcting IOLs are available commercially for Modern Phaco, Microphaco and Lenticular Refractive Surgery.
Present International Book on Mastering IOLs, the first of its kind in ophthalmic world contains 66 chapters covering all aspects of IOLs from their evolution to IOL Power Calculation Formulas, Phaco, Microphaco Lenticular Refractive Surgery Lenses, Recent Advances and Future Prospects. A galaxy of Top International IOL experts have shared their experiences in form of chapters for the benefit of the readers. An exhaustive details about various IOL power calculation formulas, various lens designs, insertion techniques, complications management and recent IOL designs have been provided in this book at a single platform for the first time in ophthalmology.
We are highly thankful to our publisher M/s Jaypee Brothers Medical Publishers Pvt Ltd specially
Sh Jitendar P Vij (CMD), Mr Tarun Duneja (GM-Publishing) and all staff members, who with their hard work and dedication composed and printed this mega book in a short time.
We are hopeful that this mega volume on Mastering IOLs shall be useful companion to ophthalmologists in their day-to-day clinical practice and shall be Gita and Bible of Ophthalmology.
Editors