Gems of Ophthalmology—Cataract Surgery HV Nema, Nitin Nema
INDEX
Page numbers followed by b refer to box, f refer to figure, and t refer to table
A
Acinetobacter baumannii 477
Akinesia 4
Akreos intraocular lens 193, 193f
All India Ophthalmological Society 478
Amblyopia
deprivational 52f
irreversible deprivational 50
management of 98
American Society of Cataract and Refractive Surgery 41, 374
Anesthesia 154, 289, 352, 407
Anesthetic solution, composition of 3
Angiography 111
Angle closure glaucoma 315
Anionic lipopolysaccharide molecules 477
Aniridia 360
Anterior capsular
contraction syndrome 297
fibrosis 259, 354f
phimosis, postoperative 358f
tear 297, 414
Anterior capsule
management 66
opacification 91f
staining 125t
Anterior capsulorhexis 134
Anterior capsulotomy 77f, 265
Anterior chamber
depth 188, 209211, 225, 252, 340, 341, 351
implantation 224, 422, 423
lens 435, 437f
reaction 485f
Anterior lens capsule 269f
Anterior uveitis, postoperative 87
Antibiotics, subconjunctival 470
Antiglare technology 194
Anti-inflammatory drugs 332
Aphakic glasses 54, 55f
Aphakic glaucoma 98
Argentinean sign 297
A-scan biometers 211
Aspheric optics 194
Aspiration system 71
Assia pupil expander 323
Atropine 324, 325
Attention deficit disorders 413
Axial length, measurement of 242, 348
B
Bacillus cereus endophthalmitis 486
Bacterial endophthalmitis, postoperative 462
Bacterial endotoxin residues 482
Balanced salt solution 40f, 115, 379, 456, 483
Bar diagram 310f
Bard-Parker handle 2, 2f
Beehler pupil dilator 319
Bent needle cystotome 69f
Berger's space 393
Best-corrected visual acuity 86, 175, 222f, 342f, 463f, 465f, 466f, 473f, 474f
poor 363
postoperative 310t
preoperative 310t
Bhattacharjee ring 321
B-hex ring 322f
Binkhorst's formula 241, 247
Blepharitis, chronic bacterial 469
Blumenthal technique, modified 19
Blunt cannula 5
Blurry vision 488
Bridle suture 5
Brittle fracture
Griffith's equation of 304b
Griffith's theory of 302, 302b
B-scan 484, 486, 487f
Bull's-eye lens 180f
Bullous keratopathy 342
Buphthalmos 361
C
Cadaver eye specimens 271f
Calhoun vision 197
Can-opener
capsulotomy 11, 71f
technique 14
Capsular bag 81f, 140f, 143, 443, 450
opacification of 89, 91f
severe degree of 450f
total dislocation of 450
Capsular block syndrome 414
Capsular dyes 84f, 111, 114, 119, 142f
nontoxic 141
preparation of 114
Capsular fixation 78
Capsular opacification 270
Capsular opening 11
Capsular plaques, dense posterior 355
Capsular retractor 367
Capsular ring size 363
Capsular stabilization device 368f
Capsular tension ring 355, 363, 366
indications of 366t
modified 364, 366, 366t
standard 363, 364f
Capsular tension segment 365, 366, 366f, 366t
CAPSULaser capsulotomy 277
CAPSULaser device 274
console 273f
Capsule contraction syndrome 439, 439f
Capsulorhexis 12, 12f, 13f, 19, 111, 112, 154, 284f, 290, 293, 308f, 318f, 340, 353, 442, 450f
anterior 114
bimanual 294f
dye-enhanced anterior 112
forceps 69f
manual 416, 417f
technique of 12
Capsulotomy 169, 267f, 275f, 397, 414, 417f
bipolar radiofrequency 74
circular 12
disk edge, scanning electron microscopy of 277
incomplete 414
Cataract 134, 205, 328, 329f, 333f, 404
age-related 287
anterior polar 151
bilateral
congenital 53f
total 50, 50f
brown 21f
black 19
classical posterior polar 150f
complicated 287
congenital 286
dense nuclear 51
development 345
developmental 286
extraction 396
intracapsular 1, 31, 153, 363
formation of 209, 229
hypermature 19, 125, 132, 361, 401
absorbed sclerotic 287, 288
morgagnian 287, 288
intumescent 288f, 292, 293f
cortical 286
management of 98
metabolic 287
morphology 289
postvitrectomy 356f
presenile 286
radiation-induced 287
subluxated 363, 401, 402f
surgery 3, 48, 49, 65, 85f, 95, 96, 112, 123, 153, 161, 179, 266, 301, 342f, 397, 408f, 434, 454
bilateral 55f
congenital 78
dye-enhanced 111, 142t
types of 383
unilateral congenital 52f
uveitis-associated 328
wound 450
Cataractogenesis 232
Ceftazidime 463f
Cell 456
density 213, 310
Central corneal thickness 211
Central posterior capsule
rupture 445
spindle shaped defect of 150f
Chalcosis 362
Chemotherapy 388
Chondroitin sulfate-based materials 339
Chopping techniques 304f
Choroidal hemorrhage 262, 377
Choroidal neovascularized membrane, recurrent 357
Ciliary body 330
Ciliary muscle 190f
contacted 190f
Ciliary sulcus 251, 443, 446
fixation 81f, 85
Cionni's modified capsular tension ring 365f
Ciprofloxacin 459, 460
Circular capsulotomy 400f
Clear corneal
cataract surgery, sutureless 28
incisions 28, 31, 32, 33f, 34f, 39f, 42, 267
Clear subluxated lens, management of 362
Cluster infection 477
Coaxial microincision phacoemulsification 179
Colenbrander's formula 241, 245
modifications of 241
Colistin methanesulfate 477
Colistin sulfonylmethate 477
Collamer implantable lens 230f
Collamer lens, implantable 208
Collateral tissue trauma 270
Coloboma, inferior 450f
Compressible disc lens, total dislocation of 444f
Conjunctiva 30f, 35
Conjunctival
chemosis 5
dissection 258
flap 6, 6f
scarring 346, 346f
Conjunctivitis, active 469
Contact lens 54, 55, 363
fitting 111
implantable 230
method 251
Continuous curvilinear capsulorhexis 11, 67, 69f, 70, 70f, 112, 132, 143, 265, 270, 340
advantages of 14
disadvantages of 14
technique 66
modified 67
Continuous loop fixation technique 257
Continuous tear anterior capsulotomy 66
Conventional extracapsular cataract extraction 1, 382
Conventional phacoemulsification 399
Cookie cutter appearance 159
Cornea 111, 129f, 342f, 351
dioptrical power of 210
Corneal abscess 461, 468f
Corneal decompensation 88, 205, 434
Corneal deformity, progressive 210
Corneal diseases 337
Corneal dystrophies 337
Corneal edema 88, 270, 332, 375, 376, 485, 486f, 489
transient 88
Corneal endothelial cell
density 210, 212
loss of 229
Corneal endothelial dystrophy, advanced 35
Corneal endothelial functions 488
Corneal endothelium 127, 225
compromised 346
Corneal forceps 2, 2f
Corneal injury, peripheral 351
Corneal involvement 476f
Corneal limbal incision 30f
Corneal opacities 413
Corneal power calculation after refractive surgery 251
Corneal scar 337, 404
Corneal shelf incision 29f
Corneal thickness 210
Corneal transplantation 253
Corneal tunnel incisions, classification of 32b, 32t
Corneal vascularization 56
Corneal wound 173
Cortex aspiration 21, 22f, 24
bimanual 159
Crescent knife 2f
Crouzon syndrome 361
Crystalline iris diaphragm 234
Crystalline lens 69f
congenital subluxation of 361f
progressive subluxation of 363
Crystalloid, anterior 225
Cyclitic membrane 361
Cyclodialysis spatula 2f
Cysteine, deficiency of 360
Cystoid macular edema 79, 96, 335f, 347, 348, 376, 434
Cystotome 2f, 12f
D
Deep-seated eyes 10
Descemet's membrane 36, 36f, 338
Descemet's valve 445
Dexamethasone 88
Diabetes mellitus 383
Diamond keratome
enters anterior chamber 36f
tip of 37f
Dislocated intraocular lenses, management of 449
Dislocated lens 413
fragments 378
possible complications of 375
Distance vision, excellent 187
Double-suture fixation 257
Dry eye 111
Duet Kelman phakic intraocular lens 224t
Dyes in ophthalmology, use of 111t
Dysphotopsia 206, 232
E
Eales disease 362
Ectasia 210
Ectopia lentis et pupillae 360
Eczema, periorbital 89
Ehlers-Danlos syndrome 361
Elastic acrylics 203
Electron microscopy 147
Elliptical intraocular
lens 191f
pressure 191
Elschnig's pearl 383, 384f
Emmetropic intraocular lens power calculation 241t
Endocapsular devices 363
Endocapsular tension rings 372
Endophthalmitis 88, 256, 448, 456, 457, 461, 462, 465, 467, 468f, 469, 476f, 477, 478, 484, 487f
acute 459
after intravitreal avastin 476f
chronic 464
classification of 455b
commonly used intravitreal drugs in 462t
endogenous 455
infectious 455, 485, 486
infective 456t
postoperative 454, 455, 457, 472, 481, 484t
post-traumatic 455
pseudophakic 455
recurrent 461
severe 461
vitrectomy study 455
Endothelial cell 340b
analysis 436
count 111, 225
damage 232
density 224
loss 223
survival 234
Endothelial guttate 342f
Endothelium 338
protection of 338
Envelope capsulotomy 11
Envelope technique 14
Epikeratophakia 57
Epinephrine 324, 325
Epinucleus removal 158
Epithelial defects 111
Epithelial dystrophy 343
Escherichia coli 376
Extracapsular cataract extraction 30, 374
Eyes
with small palpebral apertures 413
with white cataracts, slit-lamp evaluation of 290t
without silicone oil tamponade 348
F
Facial
block 4
structure 55f
False halo sign 294f
Fascia lata 257
Femtosecond 406
capsulotomy 402f
laser 399, 400f, 401, 403, 406
laser assisted
arcuate keratotomy 399f
capsulotomy 416, 417f
cataract surgery 1, 266, 322, 396, 406, 407, 413
corneal incisions 415f
laser delivery 397
laser platform 408f
laser system 398f
Fibrosis 383, 435, 436
Fibrotic anterior capsular rent 354f
Fine curved capsulotomy scissors 424
Fine-Thornton fixation ring 39f
Fire cracker injury 52f
Fishhook technique 19
Flat iris 225
Flieringa's ring 347
Floppy iris syndrome 403
Fluid turbulence, high degrees of 340
Fluorescein sodium 82, 111, 112, 115, 119f, 123, 124f, 143
solution 114
Free-floating capsules 276f
Frown incision 8f
Fuchs’ endothelial dystrophy 337, 342f
Fuchs’ heterochromic uveitis 289
Fugo plasma blade anterior capsulotomy 74
Fungal
endophthalmitis 461, 464, 470f, 471f
infection 477
Fungi 455
Fyodorov's formula 241
G
Gatifloxacin 459, 460
Gimbel's technique 140
Glare, low rate of 234
Glaucoma 95, 205, 209, 376, 413
development of 96, 446
diagnosis of 96
pseudophakic 95
secondary 363, 375, 385, 434
Glutaraldehyde 88
Gonioscopy 484, 488
Graether silicone pupil dilator 320
H
Haemophilus influenzae 455
Haigis formula 171, 248
Haptic 193, 435
deformation 438
Hard cataract 301
severe subluxation of 370f
Hard nucleus 157
Hemorrhage
retrobulbar 3
suprachoroidal 351
vitreous 84, 375, 377, 434, 450
subconjunctival 5, 35, 414
Heritable systemic syndromes 361
High refractive
defects, correction of 205
index 195
High viscosity ophthalmic viscosurgical device 291
Hoffer formula 60, 241, 245
Hoffer mean-value method 251
Holladay formula 60, 244247
Holladay-Godwin pupillary gauge 214
Homocystinuria 361
Hyaluronic acid, exogenous 384
Hyaluronidase 3
Hybrid polymers 203
Hydrating incisions 325
Hydrodelineation 15, 16, 129f, 132, 155
Hydrodissection 15, 17, 76, 129f, 132, 143, 295, 353
cannula 2f, 156f
enhanced cortical clean-up 387
steps 353
Hydrophilic acrylic 195
Hydroprocedure 15, 155
Hydroprolapse 16f, 17
Hydroxy propyl methyl cellulose 339
Hydroxyethylmethacrylate 230
Hyperlysinemia 361
Hyperopia 205, 231
Hyphema 332, 434
Hypopyon 456, 457, 485f, 486f, 488
Hypoxic corneal ulcerations 56
I
Imipenem 477
Incision 154, 352, 414, 415f
posterior lip of 37f
stromal hydration of 40f
Indocyanine green 111, 123, 137f, 143
Inflammation 270, 485
chronic 229
intraocular 375, 376
subclinical 205
Intracameral subcapsular injection 114, 124f, 126
Intraocular lens 57f, 60f, 94, 112, 140, 153, 172, 179, 186f, 190, 203, 233, 240, 296, 331, 381, 382, 387, 420, 433, 467f, 483
anterior chamber 351
aspheric 201
bifocal diffraction 183
blue light-filtering 197, 198
centered 370f
choice of 161, 350
decentration 95
design 383, 387
exchange 173
foldable 28, 181
human optics accommodative 189, 189f
implantation 14, 24, 25f, 46, 57, 160, 255, 337, 355, 412
primary 78
secondary 78, 420
malpositioned 433
material 382
monofocal 179
multifocal 167, 180
optic capture 81
power calculation 175, 240, 250, 251
accuracy of 253
power considerations 348
power formulae 241
power selection 60
scleral fixation of 363, 371f
trans-scleral fixation of 258
Intraocular pressure 96, 223, 256, 362, 376, 408, 456, 484, 485
elevation of 229
measurement 484
measurement of 329
Intraocular surgery 3
Intraocular tumors 362
Intraoperative floppy iris syndrome 315, 316, 324
classification of 324
management 324
Intravitreal antibiotics 458f
newer 473
Intravitreal avastin 465
Intravitreal ganciclovir 455
Intravitreal injection 455, 477
Intravitreal triamcinolone 455
Intravitreal vancomycin 463f
Iridectomy 56f, 443f
Iridotomy 232
Iris 111, 351
billowing of 324
claw artisan 207f
claw phakic intraocular lens, disadvantages of 234
fixated anterior chamber 255
fixation sutures 446
hooks 320, 355
mid peripheral 228f
retraction 229
retractors 319
supported lenses 435
Iritis 488
Irrigating vectis 2f
technique 19, 20 20f, 21f
J
Juvenile rheumatoid arthritis 330
K
Kaufman hand held device 425
Kellan's corneal limbal stab incision 30f
Kelman-McPherson forceps 423
Keratitis 455
diagnosis of 111
infective 56
Keratoconus 337, 343
Keratome 2f
Keratometric values 210
Keratoplasty, penetrating 337, 447
Kloti radiofrequency
bipolar unit 81
device 75
diathermy 75f
Knotless scleral fixation 258
Koch method 251
Kuglen hooks 319
L
Lacrimal drainage system, infections of 469
Large central corneal ulcer 361
Laser-assisted in situ keratomileusis 34, 171
Leicester hook 442
Lens 111, 351
bilateral subluxation of 362f
deposits 229
epithelial cells 381
iris diaphragm retropulsion 347
opacities classification system 250, 308, 309
spontaneous late subluxation of 360
substance removal 76
facilitation of 77
Lenticular contents 68
Lewis technique 447
Lieberman eye speculum 2
Light adjustable lens 197, 198f
Lignocaine 3
solution 3
Limbal
corneal incision 32
groove incision 257
pathologies 343
relaxing incisions 31, 172
Lin Gaussian-optics 251
Little's technique 13
Lloyd and Gill formula 245
Lobster claw lens implantation 425
Lowers astigmatic aberration 195
Lucentis scores 466
M
Macular edema 415
peripheral 357
Macular function tests 289
Macular pathology 229
Maloney topography method 251
Malyugin ring 320, 321, 321f, 404f
Marfan's syndrome 361, 362f, 372
McCannel suture 436, 442
McFarland's long scleral tunnel incision 29
McPherson forceps 447
Membrane formation, secondary 91
Microcornea 53f, 151
Microincision cataract surgery
biaxial 322
bimanual 158
Microincision lens 192
Microphthalmia 151
Microphthalmos 53f
Microrhexis scissors, use of 354f
Microscope alignment 341
Microvitreoretinal blade 65, 72, 259f
Migration 383
Milverton perfect pupil 320
Miosis, progressive intraoperative 325
Miotic drugs, intracameral 325
Miotic pupil 351
Miyake-Apple
imaging 270
posterior
video/photographic technique 117
view 116f, 124f
Morcher capsular tension rings 364f
Morcher incomplete circle 320
Morgagnian cataract 13f
Moxifloxacin 459, 460
Multifocal intraocular lens
diffractive 181f
second generation of 167
Multiple equidistant sphincterotomies 319
Multiple radial relaxing incisions 14
Mydriatics, intracameral 316
Myopia, high 361
N
Nagahara's chop 311t
Nagahara's phaco chop techniques 302
Nasolacrimal duct obstruction 89
Near vision, excellent 187
Neodymium-doped yttrium aluminum garnet 133
laser 159, 289
iridoplasty 363
posterior capsulotomy 79, 82, 92f, 333, 385, 385f
Night vision 209
Nitinol ring, cross-section of 269f
Noninfectious inflammation 89
Nonsteroidal anti-inflammatory drug 24, 315, 348
Nuclear
division 312
drop/dropped lens fragment 351
emulsification 132
fragments 340, 374
opalescence 308
Nucleus
delivery of 19
management 17, 295, 353, 414
sculpting 143
Sinskey hook prolapse of 18f
spontaneous dislocation of 161
stabilization of 311
Nystagmus 413
O
Ocular anesthesia 2
Olsen formula 247
Open loop semiflexible anterior chamber lens 422f
Ophthalmic dyes, nontoxic 111
Ophthalmic viscosurgical devices 339
Optic
body 193
capture 140f
decentration 437, 439
diameter 209
off-centering of 224
Optical biometry 248, 289
Optical coherence tomography 335f
anterior segment 211, 213f, 403f
Optical rehabilitation 54
Optical slit lamp 212
Optical systems 211
Optic-haptic junctions, higher magnification of 140f
P
Pain 484
Panophthalmitis 477
Pars plana
lensectomy 372
vitrectomy 377, 460
Pediatric
aphakia 98
correction of 54
capsulectomy 67f
cataract 76, 98, 403
characteristics of 47b
diagnosis of 46
surgery 46, 49, 57, 82, 84f, 87, 91f, 93f, 94f, 140, 143f
unilateral total 52f
eyes 68, 72
posterior capsule, management of 79
traumatic cataracts 83, 85f
uniocular cataracts 53f
Pentasodium colistimethanesulfate 477
Perfluorocarbon liquid 377, 449
Peribulbar anesthesia 4, 330
Persistent recurrent choroidal neovascularized membrane 357
Phaco energy 414
Phaco power 308
Phaco tip 308
bevel of 319f
placement of 311
Phacoemulsification 1, 2, 76, 112, 125, 128, 154, 324f, 328, 337, 340, 340b, 351t, 374, 417
complication of 374
dye-enhanced 127
standard coaxial 322
surgery 302
Phacofracture technique 19
Phacosandwich technique 19
Phakic intraocular lens 205, 216
angle supported 216, 436
iris supported 216, 225
Kelman duet angle-supported 218, 220, 221f
role of 205
Phakic refractive lens 208, 231
Phenylephrine 325
intracameral 324
Photic phenomena 234
Pie-chart 309f
Piggy back intraocular lens 97, 252
Pigment dispersion 229, 232
Pinky ball 4
Piperacillin 473
Planoconvex lenses, flipping of 243
Pneumatic retinopexy 455
Polymethylmethacrylate 55, 167, 215, 245, 298, 332, 350, 363, 438
Polymorphism 213
Polypropylene 429f
suture 436
nonabsorbable 447
Polypseudophakia 97, 250
Porcine eye model 77f
Post cataract surgery 461
Post pars plana vitrectomy 466f, 467f
Posterior capsular
dehiscence, management of 160
opacification 169, 331, 381, 382f, 384, 386f, 387, 387f, 391
development, mechanism of 383
development, types of 383
plaque 151f, 351
rhexis 356f
rupture 23, 147
Posterior capsule 25f
flap 134, 140f
management of 79, 159
opacification 54, 86, 93f, 384
polishing of 159
rent 152
rupture 84, 296f, 351
Posterior capsulectomy, primary 79
Posterior capsulorhexis 73f, 81, 81f, 142f, 351, 394f, 415
dye-enhanced 133
primary 391, 393
Posterior capsulotomy, primary 79, 80f, 81
Posterior chamber intraocular lens 59, 134, 363, 427f, 436
capsular bag fixation of 92f
implantation 86t
Posterior chamber phakic intraocular lens
advantages of 234
disadvantages of 235
Posterior continuous
circular capsulorhexis 143, 394f
curvilinear capsulorhexis 133, 137f, 140f, 160, 385, 387
Posterior lenticonus 151
Posterior lentiglobus 47
Posterior polar cataract 147, 148t, 149, 151, 151f, 160162, 403, 403f
classification 148
clinical features 148
inheritance and genetics 148
pathogenesis 147
progressive 150f
Schroeder's classification of 149t
Singh's classification of 149t
Posterior synechiae, peeling of 319, 320
Postkeratorefractive surgery 251, 337, 343
Postoperative compliant occlusion therapy 98
Post-trabeculectomy infection 477
Power vision intraocular lens 192f
Precision pulse capsulotomy 267, 269f, 271f
Pre-existing capsular dehiscence 403f
Preoperative nuclear sclerosis, degree of 345
Propionibacterium acnes 455, 461, 464
Proteus mirabilis 376
Pseudoexfoliation 17, 315, 316, 362, 403
syndrome 23
Pseudomonas aeruginosa 477
Pseudophakia 97
Pseudosunset syndrome 441
Psychosomatic disorders 151
Ptosis 4
Pupil 485
diameter 210, 214, 225
expansion devices 319, 320
nondilating 316t
nonrigid 314
ovalization 205, 209, 224, 229, 232
stretching 319
Pupillary block 224
Pupillary capture 92, 93f, 98, 439, 440f
Pupillary membrane dissection 355
Pupillary reaction 289
Pupillorhexis 331
Push-pull technique 67f
R
Radical pars plana vitrectomy 469f
Rajendra Prasad's chop 311, 311t
Rajendra Prasad's terminal chop, technique of 308f
Red eye 56
Red reflex 112
Refraction 210
Refractive lens 180
exchange 174, 175, 206
Refractive surgery 205
modern 205
Regression formulae 241, 242, 245
Retina 111
Retinal detachment 79, 84, 96, 169, 229, 256, 362, 375, 376, 434, 450
Retinal neovascular membrane 224
Retinal traction, peripheral 434
Retinal vascular
diseases 413
occlusion 3
Retinopathy
diabetic 345, 347, 348
hemorrhagic 97
proliferative diabetic 357
Retrobulbar block 3, 23
Rezoom multifocal intraocular lens 169
Rieger syndrome 361
Rigid gas permeable contact lens, use of 56f
Ring of Sommerring 383
Ringer lactate 15
Rock and roll technique 401
S
Sanders, Retzlaff and Kraff formula 60, 245
Scanning electron microscopy 271f, 416
Scheimpflug corneal analyzers 211, 212
Sclera 29f, 365f
Scleral collapse 65
Scleral corneal incision 32
Scleral fixation 258
Scleral flaps 257
Scleral groove 7
Scleral incision technique 258
Scleral pocket 260f
Scleral suture
fixation techniques 256
placement of 256
Scleral tunnel technique 258
Sclerocorneal pocket tunnel, dissection of 8
Sclerocorneal tunnel 9f
construction 6
Sclerotomy 258
Seidel's test 111
Senile cataract 286
Shamman's fudged formula 241
Shammas’ refraction method 251
Sheet's glide 422
Shepard intraocular lens 2f
Siepser hydrogel tire 320
Silicone
contact lenses 55
elasticity of 203
oil 252, 469f
and gas 345
bubble, postoperative migration of 357f
emulsified 347f
injection 345
refractive index of 252
Simcoe's cannula 2f, 21, 22
Simple ectopia lentis 360
Simple knotting over sclera 256
Single plane incisions 35
Sinskey hook 2, 17, 18, 322
Slit-lamp biomicroscopy 152
Small incision 194, 209
cataract surgery 1, 2, 112
manual 1, 2
Small pupil 22, 403, 413
microincision vitreous surgery 322
phacoemulsification 314
preoperative dilatation of 315
strategy 355
Smart lens 197, 197f
Smile incision 7
Sodium hyaluronate 393f
Soemmering's ring formation 78
Soft cataract 21
Soft gel lens 198f
Soft nucleus 157
Soft shell technique 330
Spectacle correction 54
Spherical aberration, aspheric surface eliminates 195
Spheroidal degeneration 337
Sphincterotomies, multiple 331
Squared posterior edge 203
Staar Toric intraocular lens 199, 200f
Staphylococcus aureus 89, 455
Staphylococcus epidermidis 89, 376, 455
Staphylococcus viridans 89
Staphylomas 361
Steel keratome, removal of 30f
Steroids, intensive 458f
Stress
high 303
low 303
Stretch line 24, 25f
Stretch pupilloplasty 355
Stripped Descemet's membrane 351
Sturge-Weber syndrome 361
Subarachnoid injection 3
Subcapsular cataract, posterior 147, 151
Subluxated cataract, management of 363, 371
Subluxated lenses
management of 360, 371
phacoemulsification in 365
Subluxation
moderate 367, 368f
of lens 360
acquired causes of 361
congenital causes of 360
severe 368, 369f
Sulfite-oxidase deficiency 361
Sunrise syndrome 442
Sunset syndrome 441, 441f
Superior rectus holding forceps 2, 2f
Surgery 153, 162
Sutherland's scissors 424
Suture 256
removal 455
traversing posterior chamber 429f
Synechiae 224
multiple posterior 88f
posterior 289, 329f, 333f, 334f
T
Tamponade anterior vitreous 393f
Tazobactam 473
Tecnis intraocular lens 201, 202f, 203f
Tecnis multifocal lens 185f
Terminal chop 301, 302
advantages of 310
mechanics of 302
technique 312
Theoretical formulae, modified 241
Therapeutic laser-assisted cataract surgery 407
Thin Optx lens, implantation of 196f
Tight lid speculum 23
Toric intraocular lens 199, 272f
Toxic anterior segment syndrome 456, 457, 481, 482, 484, 484t, 485, 487f, 488
Toxic endothelial cell destruction syndrome 481
Trabeculectomy 437f
Trauma 361
surgical 361
Traumatic
cataract 17, 23, 46, 56f, 83, 85, 85f, 86t, 98, 287, 401
corneal scar 56f
dislocation 205
subluxation 361
Trypan blue 111, 123, 143
Two-port anterior vitrectomy 445
U
Ulcerations 56
Ultrasound biomicroscopy 188, 189f, 211, 224, 225t
Upper respiratory tract infections 89
Urrets-Zavalia syndrome 229
Utrata forceps 13f
Uveal coloboma 360
Uveitic
cataract, phacoemulsification in 328
eyes 334f
Uveitis 87, 205, 229, 232, 329f, 333f, 362, 434
chronic 421
fibrinous 98
worsening 427
V
Valsalva maneuver 23
Van der Heijde's formula 241
Vannas scissors 14
Venturi pump irrigation 71
Verus ophthalmic caliper 266, 281, 281f
Viscoadaptive ocular viscoelastic device 317
Viscodissection 23
Viscoelastic solutions 482
Viscoexpression 19
Viscomydriasis 317, 319f, 355
Viscoprolapse 18
Visiogen dual optic accommodating intraocular lenses 190
Vision, very poor 477
Visual acuity 94f, 153, 210, 222, 310, 456, 488
and refraction, determination of 210
uncorrected 222, 310
Vitrectomized eyes, phacoemulsification in 345
Vitrectomy 111, 449, 461, 468
anterior 79, 80f
endoscopic 468
Vitrector-cut anterior capsulectomy 71
Vitrectorhexis 71, 72, 73f
Vitreoretinal
pathology 232
surgery 111, 112
Vitreous
anterior hyaloid phase of 140f
cavity depth 349
exudates 457
pressure
positive 65
pushes 66
refractive index of 252
W
Weill-Marchesani syndrome 361
Westcott's scissors 2, 2f, 5
White cataract 116f, 286, 288, 413
advanced 114f
classification 286
intumescent 287, 291
mature 401
normotensive 291
pathophysiology 287
phacoemulsification in 286
topographic evaluation of 291t
types of 290, 291, 292
ultrasonographic evaluation of 292t
White intumescent cataract 289, 402f
White mature cortical cataract 286, 287
White nuclear cataract 287
White-to-white corneal diameter 322
Windshield wiper syndrome 442
Wound
closure 24
construction 65
Y
Yttrium aluminum garnet laser 169, 232, 292
Z
Zepto precision pulse capsulotomy 266, 272
Zonular
cataracts 48f
damage 360
deficiency 365f
degeneration 362
traction 270
weakness 289, 346
Zonule of Zinn 360
Zonule, mechanical stretching of 361
×
Chapter Notes

Save Clear


Gems of Ophthalmology CATARACT SURGERY
Gems of Ophthalmology CATARACT SURGERY
Editors HV Nema MS Formerly, Professor and Head Department of Ophthalmology Institute of Medical Sciences Banaras Hindu University Varanasi, Uttar Pradesh, India Nitin Nema MS DNB Professor Department of Ophthalmology Sri Aurobindo Institute of Medical Sciences Indore, Madhya Pradesh, India
Jaypee Brothers Medical Publishers (P) Ltd
Headquarters
Jaypee Brothers Medical Publishers (P) Ltd
4838/24, Ansari Road, Daryaganj
New Delhi 110 002, India
Phone: +91-11-43574357
Fax: +91-11-43574314
Overseas Offices
J.P. Medical Ltd
83 Victoria Street, London
SW1H 0HW (UK)
Phone: +44 20 3170 8910
Fax: +44 (0)20 3008 6180
Jaypee-Highlights Medical Publishers Inc
City of Knowledge, Bld. 235, 2nd floor, Clayton
Panama City, Panama
Phone: +1 507-301-0496
Fax: +1 507-301-0499
Jaypee Brothers Medical Publishers (P) Ltd
17/1-B Babar Road, Block-B, Shaymali
Mohammadpur, Dhaka-1207
Bangladesh
Mobile: +08801912003485
Jaypee Brothers Medical Publishers (P) Ltd
Bhotahity, Kathmandu, Nepal
Phone: +977-9741283608
© 2019, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity. The CD/DVD-ROM (if any) provided in the sealed envelope with this book is complimentary and free of cost. Not meant for sale.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
Gems of Ophthalmology—Cataract Surgery
First Edition: 2019
9789352704019
Printed at
Contributors Preface
In spite of launching of “Vision 2020: The right to sight program”, cataract continues to remain the main cause of visual impairment and blindness. Cataract has become a serious public health problem in developing countries. According to WHO estimates, cataract is responsible for 51% of blindness. As the world population is rapidly aging, cataract cases are increasing and cataract backlog is accumulating each year.
With the introduction of recent technology, the cataract surgery has completely changed. During the past 50 years, a number of innovations have transformed cataract surgery from intracapsular cataract extraction to phacoemulsification with intraocular lens (IOL) implantation and near normal recovery of vision. The cataract surgery is now considered as a refractive procedure. The most significant landmark innovation was performed by Ridley in 1949 by implanting an IOL after extraction of opaque lens. However, his innovation was fiercely criticized and not adopted by majority of eye surgeons. Later, it was accepted universally. Many formulas were introduced to calculate the power of the IOL to be implanted in order to achieve excellent refractive results.
The other outstanding discovery was phacoemulsification by Charles Kelman in 1967. A small percentage of surgeons realized the value of phacoemulsification surgery and performed the surgery with implantation of rigid 5 mm IOL. Subsequently, foldable IOLs were manufactured to be used through a small 3 mm self-sealing clear corneal incision. Bifocal, toric, and accommodative IOLs are now available to suit the need of individual patients.
Besides improvisation in IOL and incision, there is refinement in the phacoemulsification machine to make the operative technique more safe, simple and rewarding. Attempts are being made to make the surgery, postoperatively drop-free procedure by injecting corticosteroid and moxifloxacin intracamerally/intravitreally.
The present book covers a wide range of topics on cataract surgery such as Manual small-incision cataract surgery, Dye-enhanced cataract surgery, Pediatric cataract Surgery and IOL Implantation, etc. A number of chapters on phacoemulsification in difficult situations such as Posterior polar cataract, White cataract, Hard cataract, and Cataract surgery in small pupil, Subluxated lens and Compromised cornea have also been included for the benefit of young cataract surgeons. We have given useful surgical tips on how to efficiently manage these cases without creating complications. The chapter on Dropped nucleus or nuclear fragment cautions the cataract surgeon where to stop.
Femtosecond laser (FL) has made its inroads in cataract surgery also. FL clear corneal incision, capsulotomy and softening of nucleus make phacoemulsification easy and provide excellent results. Chapters contributed by Sachdev and Sachdev and Nanaiah, et al. reveal merits of the new procedure. Undoubtedly, after phacoemulsification, femtolaser-assisted cataract surgery is the landmark advancement in cataract surgery because it offers precision and safety. The various safe and recent options for performing capsulotomy is described by Chakrabarti in his chapter on anterior capsulotomy.
We assure the readers that the major part of the work presented in this book comes from the Recent Advances in Ophthalmology series edited by us. In each chapter, the author/s has provided references for the benefit of those who want to read the topic in detail.
The book is multi-authored, therefore, repetition could not be avoided. Readers can take the advantage of knowing the views of different authors. However, special effort has been put to avoid ambiguity.
The book is concise and information on cataract surgery is presented in an easily readable form. It is profusely illustrated. Postgraduate students, residents, and general ophthalmologists can learn not only how to perform a safe cataract surgery but also to tackle difficult cases.
HV Nema
Nitin Nema
Acknowledgments
We wish to record our grateful thanks to all the authors for their spontaneity, cooperation and hard work. Some of them have revised their chapters. Our special thanks go to Drs Mahipal S Sachdev, Arup Chakrabarti, Rohit Om Prakash, and Venkatesh Rengaraj for contributing their chapters on a short notice.
Credit goes to Mr Jitendar P Vij (Group Chairman), and Mr Ankit Vij (Managing Director) of Jaypee Brothers Medical Publishers (P) Ltd. who have agreed to start a new series—Gems of Ophthalmology. “Cataract Surgery” is the fifth book of this series.