Recent Advances in Ophthalmology–14 HV Nema, Nitin Nema
INDEX
Page numbers followed by ‘f ’ and ‘t’ indicate figures and tables, respectively.
A
Abbott Medical Optics 117
Aberrometry-guided devices 125, 132
Ab-externo
continuous loop fixation 190
four-point fixation with haptic looping 191
insertion of suture 189
scleral fixation 190
technique, subsequent variations 189
two-point fixation 190
Ablation
depth 8
ratio 8
Acetylcysteine 303
AcrySof IQ PanOptix IOL 117
Acute retinal necrosis syndrome 276
Adeno-associated viral vectors 297
Aflibercept 217, 227, 228
after ranibizumab intravitreal injections 2 226
treated cases 269
Age-related eye disease study 227
Age-related fibrillopathy 135
Age-related macular degeneration 53, 116, 211, 222, 226, 227
trials of treatment 224t, 226t, 227t
Ahmed
capsule tension segment 173, 174, 174f, 175
CT segment 176f
glaucoma valve 80, 80f, 84f
various models of 80t
segment, steps of scleral fixation of 182f
Air pump assisted technique 29f
Akreos lens 195
Aladdin HW3.0 95, 96f
Albinism 46
Alpostadil 228
American Academy of Ophthalmology 1
American Society of Cataract and Refractive Surgery 1, 108
Amniotic membrane application 304f
Anacetrapib evaluation effects of 215
Angioanalytics 242, 243f
use of 248f
Angioarchitecture of fistulous lesions 310
Angiography
in retinal diseases 236
machine 310
AngioVue OCT angiography software 240, 240f
Aniridia 76f
with glaucoma 77
Anterior assisted levitation 165
Anterior chamber 135
depth 90, 112, 136
intraocular lens 167f
sudden deepening of 160f
Anterior lamellar keratoplasty, recent advances in 32
Anterior segment optical coherence tomography 5f, 150, 151f
Anterior vitrectomy 185
Antiangiogenic factor 264
Anti-infective agents 283
Anti-vascular endothelial growth factor drugs 214
Aphakia 91
Aphakic
eye blocked 87f
glaucoma 76
refraction 108
Arcuate
incision 119f, 120
keratotomies 123
Argon laser trabeculoplasty, treated eyes 67
Argos 97, 97f
Arrestin gene 291
Arterial
access 311
and vein occlusions 53
dissections, causing 312
thrombosis 312
Arteriovenous
fistula 312
malformation 310, 317f, 319f
passage time 55
Artifact 241
corrected by software 242f
correction of motion 241
movements 242f
projection 242
white line 242f
Artificial
intelligence-based formulae 103
pupil 50
Aspirin 280
Assisted levitation
anterior 169f
posterior 169f
Assort toric calculator 105
Astigmatic effect of surgical incision 126
Astigmatism
correct preexisting 117
location of incision to reduce 118t
management in cataract surgery 123
minimize postoperative 117
Atherosclerotic disease, severe 310
Aurolab aqueous drainage implant 78, 79f, 83f
Autoimmune diseases 12
Autologous 303
limbal transplantation 306
Autosomal recessive 288
B
Baerveldt implant 78, 85
various models of 78t
Balanced salt solution 28
Barrett
formula 130
toric calculator 106
True-K formula for IOL power calculation 109
universal 2 102
Baylor nomogram 130
Beiko and Steinert technique 202
Belin/Ambrósio enhanced ectasia 9, 10f
Bevacizumab 217, 222, 224, 227
eliminates the angiogenic threat 224
treated cases 269
Bimanual irrigation and aspiration 164
Binkhorst regression 97
Bioimaging biomarkers 268269
Biomechanical elasticity theory 11
Biometry 90, 112
Bioptics 123, 131
Blood-retinal barrier, outer 264
Blunt trauma 171
Branch retinal vein occlusion 211, 222, 246, 248
evaluation of efficacy and safety 222
Branched retinal artery occlusion 247
vascular network 255f
Brimonidine 228
Brown's syndrome 85
Bruch's membrane 239
Bubble, types of 25f
Burst mode power modulation 114f
C
Calcium channel blockers 64
Callisto 93f
Camellin-Calossi for postrefractive eyes 97
Candesartan 213
Cannula-based intrascleral tuck 203
Capillary dropout 239
nonperfusion 277
phase 315f
Capsular bag 172f
devices 174f
fibrosis 199f
IOL complex, late spontaneous dislocation of 199f
support, choice of 77f
Capsular hooks 172
with long blunt loop 173f
Capsular support device 179
for subluxated lenses 171
Capsular tension ring 141, 177
insertion steps 181f
Capsule
assessment of 166f
careful assessment of 164
retractors 143
tension ring 173
different sizes of 175
insertion, technique of 180
tension segment 142
Capsulorhexis 140, 178
construction 127f
strategies for 179
Carcinoma-associated retinopathy 287
Cardiovascular risk in type 2 diabetes 213
Carotid artery
external 311, 313
internal 311
left internal 320f
right external 313
right internal 314, 315, 316, 317, 317f
Carotid-cavernous fistula 310, 320f
Cataract
density 136
postvitrectomy 159f
surgery 90, 112, 121, 123, 156, 320
Cell division theory 68
Central
anterior vitrectomy 164
corneal thickness 96
macular subfield thickness 216
permanent tarsorrhaphy 304
retinal vein occlusion 211, 221, 222, 246247, 249
serous chorioretinopathy 254
case of 256f
subfield thickness 217, 218, 268
subfoveal 262
vein occlusion study 222
Cerebral angiography 312f, 321
3D-digital subtraction angiography 315
advances in 315
case studies 317321
complications 312
contraindications 310
in neuro-ophthalmology 309
indications for 310
preprocedural workup 310
procedure 311
role of 309
used for 312
Cerebral arterial metameric syndrome 319f
Cerebral artery, left middle 321f
Champagne bubbles 70f
Chemical burns 76
Chikungunya retinitis 282
mimic herpetic 282
Choriocapillaries 241, 254
Chorioretinal lesions 283
Choroid 250f
Choroidal dystrophies choroideremia 288
Choroidal effusion 85
Choroidal neovascular membrane 226228, 254
complex, size of 254f
Choroidal neovascularization 226227, 239, 253, 283
type I, type II, type III 253
Choroideremia 293, 296
with stellate macula 294f
Cicatricial pemphigoid 76
Ciliary neurotrophic factor 228, 297
Ciliary processes 135
Ciliary sulcus 189
fixation 186
position of 197
sclerotomy 200
Cilioretinal artery 249f
Cionni ring 173, 174f, 175
Coaxial irrigation aspiration 164f
Collagen cross-linking 12
for management of 14f
Collateral formation 246
Color Doppler imaging 55
advantages 56
limitations 56
imaging machine 55f
Cone-rod dystrophy 292
Congenital
chorioretinal scarring 283
glaucoma 45
stationary night blindness 287, 288, 290
Conjunctiva 88f, 302
mobility 80
limbal autografting 306
Conjunctival peritomy 200
Contact lenses 13
Continuous curvilinear capsulorhexis 140
Continuous mode power modulation 113f
Contrast-induced renal failure 312
Copaxone 228
Cornea for severe ocular burns 304f
Corneal
asphericity 6
astigmatism 123
preoperative assessment 123
surgical methods for treating 126
calcification 45
edema 205
severe 24
endothelial cell 199
evaluation 135
hydrops, acute 32
incisions 127f
infection 12
irregularities 49
neovascularization 45
pachymetry 47
patch graft 82f
power 112
stroma in isotonic 12
thickness spatial profile 9
tomography measures global corneal astigmatism 124
topography 4f, 6, 7f, 16, 18f, 47
touch and decompensation 89
vascularization 305
Cortical
aspiration 180
cleaving hydrodissection 179
material, removal of 140
Cosmetic keratopigmentation 45
case 45, 48f
Cultivated limbal epithelial transplantation 306
Cycloplegic agents 303
Cyclotorsion 124
Cylindrical correction of toric IOL 121
Cystitome depresses 178f
Cystoid macular edema 89, 156, 157f, 195, 205
development of 196
Cytomegalovirus 274, 275, 276, 279
intravitreal therapy 282
retinitis 274, 280, 281f
treatment 282
D
Debris, tube blocked 88f
Deep anterior lamellar keratoplasty 23
Deep capillary plexus 241
Deep inner retina OCT angiogram segmentation 241
Deep layer 249
Deeper en face angiograms 242
Dengue
ophthalmic complications 283
related foveolitis 283
virus retinopathy 283
Deoxyribonucleic acid viruses 274
Descemet's membrane 35
endothelial keratoplasty 23
Descemet's stripping automated endothelial keratoplasty 23
Diabetes control and complications trial 213
Diabetes mellitus
control of 212
prevalence of 260
Diabetic macular edema 211, 213, 214, 215, 216, 220, 269, 269f, 270f
antivascular endothelial growth factor 214t
bilateral 218
bioimaging biomarkers in 268
lasers in 214t
patient compliance 219
SD-OCT-based morphological classification of 266
trials with corticosteroids in 216t
Diabetic maculopathy 214
Diabetic patient with moderate NPDR 245f
Diabetic retinopathy 211, 212, 213, 243, 260
candesartan trials 213
clinical research 214, 215, 216, 220, 221
occurrence/progression of 213t
study 220
study, early treatment for 214
systemic factors 213t
vitrectomy study 221
Diamond calibrated knife 41f
Diffuse corneal opacity 46
Diffuse slit lamp examination 137f
Diffuse subarachnoid hemorrhage 316f
Diffusion weighted imaging 321f
Digital
image-guided systems 126
subtraction angiography 310
Disability affected life years 17
Dislocated capsular bag-IOL complex 199f
Donor
corneoscleral graft 24
scleral patch graft 84f
tissue for allogeneic limbal transplantation 306
Doppler optical coherence tomography 59
advantages 59
limitations 59
Doppler velocimetry 53
Drainage devices, current 77
Drug toxicity 295
Dry age-related macular degeneration 223, 252
Duke-Elder's classification 147
Dural arteriovenous fistula 310
E
Ectasia cases 7
Ectropion 305
Edema, resolution of 36
Efficacy versus effectiveness 211
Ellipsoid zone 263
Ellipsoid zone, classification of 263
Emphysema 34
En face OCT 247f
Enalapril 213
End-diastolic volume 55
Endocapsular placement 184
Endoilluminator-assisted descemet's membrane endothelial keratoplasty 24, 26f
Endophthalmitis 89, 156, 157f, 195, 197, 205
Endoscopy-assisted scleral-fixated IOL 191
Endothelial keratoplasty 23
recent advances in 23
Endovascular procedures 317
Enface optical coherence tomography 267, 268f
advantages of 267
Enface thickness maps 267
Entropion 305
Epinuclear plate 154
Episcleritis 277
Epithelial downgrowth 77
Epstein-Barr virus 274
Ethylenediaminetetraacetic acid 45
Excessive conjunctival scarring 76
External limiting membrane 263, 265f, 270
Extraocular
blood 196
needle-guided haptic insertion technique 203
Exuberant vascular proliferation 246
Eyelid malpositions 305
EyePro application 109
Eyes
chronic rubbing of 9
undergoing penetrating keratoplasty 197
Eyestar 900 98, 99f
F
Famciclovir 279
Femto laser-assisted arcuate keratotomy 119f
Femtodelineation technique 152, 153f
Femtosecond laser 112, 128
Femtosecond laser-assisted
arcuate keratotomy 117, 118, 129f
cataract surgery 147, 149, 150
intrastromal keratopigmentation technique 43f, 44f
LASIK 132
Fenofibrate 213
intervention 213
Fetal posterior cerebral artery 313f
Fibrinous membrane 87f
Fibronectin 131
Fibrovascular pannus formation 305
Finesse flex loop 203
Fish-tail technique 173
Flaccid bag taut 175f
Flap replacement surgery 16
Fluocinolone acetonide intravitreal implant 216t
Fluorescein angiography 244246, 248
Fluorescein staining of ocular surface 304f
Focal disruption 264f
Foci of retinal necrosis 275
Food and Drug Administration 60
Fornix based conjunctival flap sutured 84
Foscarnet 279
Foveal
avascular zone 246
retinal inner layers 269
Fuchs’ dystrophy 45, 116
Fundus
albipunctatus 291
evaluation 46
fluorescein angiography 249, 277
typical retinitis pigmentosa 289f
xerophthalmicus 292
G
Galilei G6 97f, 98
Ganciclovir 282
Ganglion cell
complex 61f
layer 241, 262
Gaussian optics assumes 104
Gene therapy 297
Glaucoma
in pregnancy 68
primary 138
secondary 156
Glaucoma drainage devices 74, 75, 86f, 87f
choosing 81
indications of 76f
types of 74
Glaucomatous eyes 55
Global disruption 264f
Glued
intraocular lens 168f
intrascleral haptic fixation 200
IOL, sutureless 201f
Goldmann three-mirror goniolens 69
Gore-Tex suture 192f
Graft injected into anterior chamber 30f
Gyrate atrophy 293, 294f, 296
H
Haigis 101
Haigis-L formula 107
Handshake technique 200, 202f
Haptic
double suture fixation to 190
eyelet 192f
looping method 190
tucked, tunnel 201f
Headache, sudden severe 317
Hemoglobin A1C 213
Henderson capsule tension ring 174f
Hepatitis B surface antigen 310
Herpes simplex viruses 274
Herpetic phase, acute 277
Herpetic retinitis 274
Herpetic retinopathies 275
features of 279t
Hill-RBF calculator 103
Hoffer-Savini LASIK IOL power tool 108
Hoffman elbow 85
Hoffman's pouch 194f
dissection of 194f
Holladay
IOL consultant toric preoperative planner 106
Schema-9, types of eyes 103t
Homocystinuria 171
Host Descemetic scaffolding 31, 31f, 32f, 33f
Human immunodeficiency virus 274, 310
Hybrid lens 13f
Hydrodelineation 149f
Hydrodissection 140, 179
Hypertension in diabetes study 213
Hyphema 85
Hypotony 85
early postoperative 79
maculopathy 89
postoperative 204
I
Iluvien acetonide 228
Implants, functioning of 74
Indocyanine green 53
angiography 236
investigations with 223
Inferonasal quadrant 86f
Inferotemporal BRVO, case of
Inflammation, types of 274
necrotizing 274
non-necrotizing 274
Informed consent 310
Injectable suture device 190
Internal limiting membrane 239
Interventional radiology 309
Intracameral
gas 32
tube 81
Intracapsular cataract extraction 186
Intracorneal ring
segments 14
segments management of 15f
Intractable glaucoma shunts 74
complications 85
management of 74
placement of tube 85
preoperative evaluation 80
site of implantation 85
surgical procedure 81
use of antifibrotics 85
Intralamellar keratoplasty 16
Intraocular ab-externo suture fixation 190
Intraocular inflammation 282
Intraocular lens 184, 288
first implanted in 1949 90
fixation 143
implantation 95, 164
sutured scleral-fixated 168f
insertion 181
Master 500 93, 93f
Master 700 94, 95f
positioning 127f
power 186
calculation 130
classification 101
formulae 100
in eyes 107
recent advances in 90
secondary 23
selection 115, 143, 199
for scleral fixation 185
single piece 167f
three piece 167f
types of 185
Intraocular pressure 53, 67, 74, 199
lowering drugs 64
Intraoperative aberrometry 99, 108
floppy iris syndrome 115
Intrascleral
sutureless haptic fixation, surgical technique of 199
tunnel 200
Intrastromal
corneal dissectors 41f
keratopigmentation 42
instruments of 41f
tunnel 50
Intravitreal
antiviral therapy 280
triamcinolone acetonide 214, 216, 222
vascular endothelial growth factor 253
Iridocorneal endothelial syndrome 46, 76
Iridodialysis 46
Iris
claw lens 143, 168f
coloboma 39, 46, 49
cysts, progressive 46
hooks 171, 172f
retractors 180f
Ischemic maculopathy 283
Ischemic retinopathies, cases of 242
J
Jacob technique 32
for primary pre-descemetic deep anterior lamellar keratoplasty 36f
Joseph valve 74
K
Keratitis 277
Keratoconus 5
Keratocyte density, loss of 11
Keratometry 93, 124
Keratopigmentation 4546
complications 49
contraindications to 47
device for superficial automated 40f
functional therapeutic 47f
indications 45
innovative surgical option for 39
instruments 40
pigment selection 40
practice of 39
surgical techniques 42
technologies 40
therapeutic functional 46
Keratoplasty 16
Keratoprosthesis, type-1 307f
Knot erosion 193
intraocular lens tilt 193
use of scleral flaps 193
use of scleral grooves 193
Koch nomogram 118
Krupin
implants 79
valve 74
Kyriele's plaques 281
L
Ladas super formula 102
Lagophthalmos 305
Lamellar keratoplasty, recent advances in 23
Lamellar scleral flaps 189, 202f
dissection of 201f
Lamellar scleral graft 196f
Lampalizumab 228
Laser Doppler flowmetry 53, 58
advantages 58
limitations 58
Laser Doppler velocimetry 57
advantages 57
limitations 58
Laser in situ-keratomileusis 131
Laser photocoagulation 223
Laser speckle flowgraphy 54
Laser-assisted in situ keratomileusis 1, 112
Lasers in glaucoma, role of 67
Lens fragmentation 152
Lens touch 87f
Lenstar LS 900 94, 94f
Leukomatous corneas, management of 39
Lid margins 302
Limbal groove 199f
incision 190
Limbal relaxing incision 123, 117118, 125, 128
Limbal stem cell deficiency 302, 305f
Limbal transplants visible on ocular surface 306f
Lipid-modification 215
Lisinopril 213
Loading dosage 217
Lock-and-lead technique 203
Losartan 64, 213
Low-density lipoprotein 213
Lutein antioxidant supplementation trial 227
Lymphoma 276
M
MacTel stage 5 252f
Macular edema
assessment of implantable dexamethasone 216
due to retinal vein occlusion 222
Macular telangiectasia type 2 248
Macular thickness map 270f
Magnetic resonance imaging 49
Malyugin ring 140
Manual intrastromal keratopigmentation 42
Manual small incision cataract surgery 140
Marfan syndrome 171
Masket method 107
modified 108
Matrix metalloproteinase 11
Maximum intensity projection 316
McCarthy post refractive IOL calculator 109
Mean dye velocity 55
Melanoma-associated retinopathy 287
Melles technique of optical recognition 35f
Mesenchymal stem cells 297
Michelson interferometer 92
Microaneuryms and vascular beading 244f
Microaneurysms development of 243
Microbial contamination 195
Microcatheters, use of 203
Microincisional cataract surgery
advantages in difficult situations 115
in customization, role of 115
Microkeratome-assisted LASIK 132
Microkeratome intraocular pressure 132
Micronized mineral pigments 41
advantages of 41
Microrhexis forceps 158
Microsurgical technology 172
Microvascular abnormalities 246
Microvitreoretinal forceps, using 23-gauge 194f
Middle cerebral artery 313
Migraine 63
Minimal pre-descemetic stroma 35
Missed ectatic pathologies 16
Mitomycin-C 85
Mixed keratopigmentation 43
Miyake-Apple view 175f
Mizuo phenomenon 291, 292f
Molteno implant 77
various models of 77t
Morcher capsule tension ring 174f
Motility disturbances 85
Moxaverine 228
Multifocal intraocular lens 116, 116f
Multifocal IOLs 117
Myopia, high 8
N
Necrotizing retinopathies 274
clinical features 276
etiology 276
Neodymium:yttrium aluminum garnet laser 67
Neovascular
age-related macular degeneration 211, 223
complex 243f
glaucoma 68, 76
case of 85
tuft 245f
Nerve fiber layer 239
Neural progenitor cells 297
Neuroprotective agent 297
Neuroprotector 228
Neuroretinal changes, signs of 262
Nidek claims 96
Nifedipine 64
Night blindness 297
Nitinol flex loop 203
Noncontrast computed tomography 316f
Nonfoldable polymethylmethacrylate 129
Nonproliferative diabetic retinopathy 243244
Nonsteroidal anti-inflammatory drug 71, 143
Normal tension glaucoma 55
Nuclear layer, inner 239, 241
Nuclear sclerosis, grade of 114
Nucleus drop 165, 169f
Nucleus management 170
Nuijts-Solomon bubble marker 125f
Nyctalopia 287
approach to patient of 296
classification and causes of 287
clinical features of specific disorders causing 288
etiology 287
pathophysiology 295
treatment 296
O
OA 2000 99, 99f
Occlusive vasculopathy 275
OCTA machines 237t
Ocular blood flow
assessment of 53
factors affect 62
pharmacological 64
physiologic 62
systemic disease 63
in glaucoma 53
techniques for measuring 54t
Ocular burns
acute 304f
classification of 303t
emergency 302
management of 302
practical approach 302
vision restoration after severe 305
Ocular
examination 296
hypertension 64, 68
infections 45
surface
check-up for dry eye 46
diseases 76
reconstruction 305
vascular dysregulation 63
Oguchi's disease 291, 292f
Ohta Y-fixation technique 202
Okulix
ray-tracing methods 94
uses ray tracing optics 104
Olsen formula 104
Open angle glaucoma 68, 77
primary 68
secondary 68
Ophthalmic
artery, right 317
viscosurgical device 178
Ophthalmological assessment 46
Optic
atrophy 283
disk 61f, 281f
nerve head 53
blood flow of 64
Optical biometers 91, 92
advantages of 91
disadvantages of 91
Optical coherence tomography 199, 226, 236, 250, 289f
angiography 59, 236, 240f, 244, 246, 248250f, 254256
advantages 62
amplitude-based 238
complex signal-based 238
correlation 61
development timeline 60f
image processing 239
limitations 62
normal eyes 240
phase-based 237
principle of 236
quantification of 239
retinal disorders 243
in diabetic retinopathy 260
signal 241
Optical low coherence reflectometry 9192, 123
Optical microangiography 60
Optiwave
refractive analysis 100
quantification tool 242
Orbital region, right 317
Oregon Health and Science University 60
Ozurdex study 217
P
Pachymetry, preoperative 7
Panretinal photocoagulation 220, 222
Paraneoplastic retinopathy with carcinoma 294
Parenchymal abnormality 321f
Pars plana
clip 85
infusion cannula 200
phacoprosthesis 191
20-gauge vitrectomy 202f
vitrectomy 166f, 270
Partial coherence interferometry 9192, 112
Patent iridotomy 68
Peak systolic velocity 55
Pegaptanib sodium 227
Pellucid marginal degeneration 5
Penetrating keratoplasty 23
Pentacam AXL 97, 98f
Peribulbar block 81
Periocular skin 302
Peripapillary retina 281f
Peripheral
cornea 199f
corneal 128
relaxing incisions 117
iridectomy 29
retina 275, 281
zone 137
Periphlebitis 277
Perivascular retina 278
Persistent epithelial defects 305
Petrosal sinus, superior 320
Phaco probe 163
removal of 163f
Phacodonesis 137, 176
Phacoemulsification 138, 176, 177, 179, 184
in subluxated lenses 171
stage of 114
surgery, development of 112
technique 140
Phacooptics 105
Phakic intraocular lenses 45
Phosphodiesterase inhibitor 228
Photic phenomena 49
Photodynamic therapy 223, 226
Photorefractive keratectomy 8
Phthisis bulbi 46
Pial arteriovenous fistula 310
Pigment clumps 251f
Pigment epithelial detachment 253, 256
Pigment epithelium derived factor 264
Placido-disc measure 124
Plate erosion 85
Plexiform layer
inner 239, 241, 262
outer boundary of 239, 241
Pluripotent
cells 68
stem cells 297
Pneumodescemetopexy 34
Polymerase chain reaction 276
Polymethyl methacrylate intraocular lens 192f
Polymethylmethacrylate rings 173
Polypoidal choroidal vasculopathy 223, 254
Post corneal refractive surgery 107
Postcerebral angiogram 321f
Posterior assisted levitation 165
Posterior capsular
defect 151f
rupture 156
anticipation of 158
early signs of 156
important clinical pearls 158
improperly managed 156
management 156
prevention of 158
recognition of 156, 158
stages 156
tear 162f
Posterior capsule rent 115
Posterior capsulorhexis 160f
Posterior chamber intraocular lens 199, 200
Posterior corneal astigmatism 124
Posterior fossa parenchyma 313f
Posterior polar cataract 147, 150, 159f
case of 152
classification of 147
phacoemulsification in 148
timing of surgery 148
Post-laser-assisted in situ keratomileusis ectasia 2f, 4f, 5f, 13
Post-LASIK ectasia
common clinical findings 2
epidemiology 1
grading system for 6t
histopathology 11
investigations 2
management 12
management of 1
pathogenesis 9
presenting features 2
prevention 16
risk factors for 5
Power modulation 113
burst mode 113
continuous mode 113
pulse mode 113
Precise capsulotomy, creation of 150
Pre-Descemet's endothelial keratoplasty 23, 24
air pump assisted 27, 29f
graft 31f, 33f
Pre-Descemetic
DALK for acute hydrops, modified tecnique 32
dissection for acute hydrops 35f
Pregnancy period 12
Premacular hyaloid growth factor reservoir 261
Premium intraocular lenses 123
Proliferative diabetic retinopathy 213, 219, 245f
clinical trials on 220t
Prophylactic laser 280
Pseudoaneurysm 312
Pseudodispersive viscoelastics 139
Pseudoexfoliation 68, 171
and cataract surgery 138
cataract: management 135
deposits on
intraocular lens 144f
pupil 137
endothelial deposits of 135
eyes 138
glaucoma 76
postoperative complications 143
preoperative evaluation 135
syndrome 135
Pseudonight blindness 287
Pseudophakia 91
Pseudophakic
eye 85
glaucoma 76
Pseudoplasticity phenomenon 178
Pulsatile ocular blood flow 54
Puncture site hematoma 312
Pupil optic zone markers 41f
Pupil size 136
Pupillary
constriction 150
margin 135
ruff 136
stretch with Kuglen hooks 139f
R
Radial keratotomy 112
Radial superior incision 44f
Radiation therapy for age-related macular degeneration 226
Randleman's ectasia
risk factor score system 6t
score 8, 17
Randomized controlled trial 221
Ranibizumab 220, 221, 222, 226, 227, 228
for choroidal neovascularization 222
for diabetic macular edema 215
for the treatment of macular edema 222
treated cases 269
Rapamycin 228
Rapid progression 275
Real-life situation 212
Refraction-based formulae 101
Refractive targeting 112
Refractory infantile glaucoma 77
Reftinal detachment 157f
Regression formulae 101
Renin-angiotensin
inhibitor 64
system study 213
Residual stromal bed 56
Retina, outer 252
Retinal
angiomatous proliferation 253
arteriovenous malformation 318
artery occlusion 247
detachment 89, 156, 195, 205
mechanism of 278
secondary 276
hemorrhage, large areas of 275
implants 297
layer: inner 262f
disorganization of 261
outer, disruption of 263
macular degeneration, late-onset 294, 287
necrosis: acute 274, 275, 276, 279
active herpetic phase of 275f
surgical management of 280
necrosis: outer, progressive 274277, 279
diagnosis 278
treatment 279
nerve fiber layer 60, 262
defect 61f
loss, inferior 64f
layer thinning of 268
oximetry 53, 58
advantages 59
limitations 59
pigment epithelium 53, 239, 251f, 264f, 288
thickness 262
transvitreal oxygenation, improvement of 261
vascular disorders
message from clinical trials 211
real life situations management of 211
vasculitis 282
vein occlusion 211, 220, 246
vessel analyzer 53, 54, 58
advantages 58
limitations 58
Retinitis pigmentosa 287, 288
atypical form of 290, 291f
typical 289, 289f, 290f
Retinopathy of prematurity 211, 223, 224, 224t
Retrobulbar hemodynamics 64
Retrogeniculate damage 283
Rheological factors 63
Rhexis in weak zonules 178f
Rhodopsin gene 288
Rhodopsin kinase 291
Riboflavin solution 12
Riggs type 290
Rigid gas permeable 12
Rod photoreceptors 287, 288
S
Scanning laser ophthalmoscopic angiography 53, 54
advantages 55
limitations 55
Scarred limbal area 81
Scharioth
forceps 200
technique 200
Scheimpflug imaging 96
dual 98
Schlemm's canal 68
Schocket procedure 77
Schroeder classification 148
Schubert-Bornschein type 290
Sclera-corneal incision 128
Scleral fixation
devices 173
Gore-Tex suture for ab-externo four-point 194f
in small eyes 197
intraocular lens 184
implantation in children 196
modification in materials for 192
sutures, techniques of 188t
two-point ab-externo 192f
with Cionni ring, technique of 180
Scleral
flaps 190
lens 13f
sutured IOLs, surgical techniques 187
Scleritis 277
Sclerocornea 46
Sclerotomies 200
Segmental retinal periarteritis 281
Selective laser trabeculoplasty 67, 69, 71, 72
advantages 68
complications 71
contraindications 68
disadvantages 68
indications 68
laser 70f
mechanism of action of 68
principle of 67
technique 69
Setons, glaucoma drainage devices 74
Shaded surface display 316
Shunts nonrestrictive 74
Shunts nonvalved 74
Siderosis 295
Silicone oil-filled eyes 91
Silicone tube 77
Simple limbal epithelial transplantation 306
Singh's classification 148
Single-piece rigid polymethyl methacrylate lens 186
Sinskey hook 28
using 194f
Slit lamp
examination 137f
marking 125f
Slit scanning corneal topography 123
Small incision cataract surgery 140141
steps of 141
Small incision technique 189
Small posterior capsular tear 158
Small pupil 139
Spectral domain-optical coherence tomography 260, 261f, 262f, 264f, 265f, 266f
analysis in diabetic retinopathy 260
Spinal vascular malformations 310
Split-spectrum amplitude-decorrelation 249
angiography 60
Staar Toric IOL 119
Standard care vs corticosteroid for retinal vein occlusion 222
Static zonulopathy 141
Steroid induced 68
Steven-Johnson syndrome 76
Stromal lamellae 11
Sturge-Weber syndrome 77
Subconjunctival hemorrhage 282
Subluxated lens 142f
surgical procedure 176, 177
Suboptimal visual 130
Subretinal hemorrhages 253
Subtenon's anesthesia 81
Subtle retinal edema 281
Superficial and deep layers 251f
Superficial anterior lamellar keratoplasty 23, 42
technique 43f
Superficial capillary plexus 243, 244
Superficial keratopigmentation 42
Superficial manual keratopigmentation 42
Superficial vascular plexus 241
Superotemporal quadrant 85
Suprachoroidal hemorrhage 85, 195196
Surface ablation, advanced 8
Suture erosion 195
Suture knot erosion 196f
Suture-assisted sutureless technique 202
Sutured scleral fixation 184
intraocular lenses 165, 195, 197
Sutured vs sutureless scleral fixation 205
Sutureless intrascleral haptic fixated 197
developed technique of 197
Sutureless scleral fixation
intraoperative complications 204
postoperative complications of 204
Suture-related modification 192
Swept-source OCT 60, 92
Sylvian fissure, right 316
Systemic corticosteroids 280
T
Tandospirone 228
Tecnis
multifocal IOL 117
toric IOL 119
Telangiectasia 246
Telecentric keratometer 95
Tenon's
cyst 89
tissue growth 77
Tissue necrosis factor, administration of 303
Topcon's Aladdin HW3.0 95
Toric
calculators 106
intraocular lens 119, 129
calculators 105
implantation 120
stability of 130
Torn zonules 171
Torsional (OZil) 114
Trabecular meshwork 67, 135
Trabeculectomy 77
Trabeculoplasty lens 69f
Tracey technologies 126
Tractional retinal detachment 283
Transient
loss of consciousness 317
vitreous hemorrhage 205
Translucent
iris 46
rendering 316
Transmission electron microscope 11
Transscleral fixation 186
in children 198t
Traumatic
cataract 158, 159f
glaucoma 68, 76
Triamcinolone, uses stain vitreous 165f
Trimetazidine 228
Tube exposure 88
Tube retraction 85
Tucked-in lamellar keratoplasty 16, 23
Tunica vasculosa lentis 147
Two-handed technique 201
Two-instrument iris stretch 139
U
Ultrasound
amplitude scan, first performed in 1956 90
biomicroscopy examination 187
customization 114
United Kingdom Prospective Diabetes Study 213
Universal Serial Bus 93
Universiol calculator 105
Urrets-Zavalia syndrome 46, 49
Utrata forceps 158
Uveitic glaucoma 68, 76
Uveitis 85
Uyemura's syndrome 292
V
Valganciclovir 282
Valved implants 79
Varicella zoster virus 274
Vascular
access 311
congestion 246
density 59
en face angiograms, percentage of 242
endothelial growth factor 220, 254, 264
lesion 310
sheathing 283
system visualization of 309
Vasospasm 63
Venous looping 246f
Vergence formulae 101
Verion planner 106
Vertebral artery 319f
right 318
Verteporfin in photodynamic therapy 226
Viral keratitis 16
Viscoelastic, injecting 163f
Visual
acuity 213
field 289f
Vitamin A deficiency 292, 293f
Vitrectomy 23
bimanual 161f
cutter 166f
for diabetic retinopathy-related vitreous haemorrhage 221t
technique 161
Vitreomacular
adhesion 261
interface analysis 260
traction 261, 261f
Vitreous hemorrhage 89, 195, 283
W
Wang-Koch modification for IOL formulae 105t
Warfarin 280
WaveTec Vision Systems 100
Waxy disk pallor 289f
Weak zonules 171
West Nile virus 282
retinopathy 282
Wet age-related macular degeneration 253
Y
Yamane's technique 203
Z
Zernike coefficient for spherical aberration 6
Zonular
instability, signs of 138
weakness, adjunctive devices for 141
Zonulodialysis 171
Zonulopathy 171
×
Chapter Notes

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Recent Advances in OPHTHALMOLOGY–14
Recent Advances in OPHTHALMOLOGY–14
Editors HV Nema MS Former 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
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Recent Advances in Ophthalmology–14
First Edition: 2019
9789352709014
Printed at
Loving memory of Pratibha
Editorial Board Contributors Preface
Like previous volumes, the RAO-14 contains chapters on selected topics on cornea, glaucoma, cataract, and retina. Corneal ectasia after LASIK is not a rare complication. It causes visual disablement and great dissatisfaction to the patient. Authors have described risk factors for the development of post-Lasik ectasia and suggested methods to prevent it. Once the complication occurs, it should be treated early. The management strategies include contact lens, intracorneal rings, collagen cross-linking and keratoplasty.
Of late, renewed interest has been generated in Lamellar Keratoplasty (LK) and many forms of LK have been introduced. Deep Anterior Lamellar Keratoplasty (DALK), Superficial Anterior Lamellar Keratoplasty (SALK) or Tucked-In Lamellar Keratoplasty (TILK) is indicated in stromal pathology with healthy endothelium. These procedures have least risk of rejection. On the other hand, Descemet Stripping Automated Endothelial Keratoplasty (DSAEK), Descemet's Membrane Endothelial Keratoplasty (DMEK), and Pre-Descemet's Endothelial Keratoplasty (PDEK) are performed in diseased endothelium with healthy stroma. Authors have described three innovative techniques to better visualize and support the graft. These include—(1) Endoilluminator-assisted PDEK, (2) Air pump-assisted PDEK and (3) Host Descemetic scaffolding to support the graft.
Keratopigmentation or tattooing was a popular technique to mask corneal opacities in the past. However, the practice of tattooing has been greatly reduced after the introduction of keratoplasty. Alio and coworkers have devised special instruments and use micronized mineral pigments and claim “Keratopigmentation is a modern surgery that provides an excellent solution for patients where other treatment options are not suitable.”
Blood supply to optic nerve plays a vital role in the pathogenesis of glaucoma. The difference between arterial blood pressure and intraocular pressure (IOP) is defined as ocular perfusion pressure (OPP). There are published reports that patients with glaucoma have low OPP as compared to normal individuals. The quantification of blood flow in the eye can provide evidence about the pathological changes in optic nerve head. The cause of reduction of OPP is not known but seems to be vascular dysregulation or insufficient autoregulation. Authors have described both invasive and noninvasive methods of assessment of the ocular blood flow as well as local and systemic factors which influence it. They feel that data are not sufficient to validate use of ocular blood flow assessment for the treatment and prognosis of glaucoma.
Selective Laser trabeculoplasty is considered a relatively safe procedure in the management of glaucoma. Authors have briefly described the mechanism of action, indications and contraindications, advantages and disadvantages, complications and outcome of the technique.
Management of intractable glaucoma poses a great challenge to ophthalmologists. Glaucoma drainage device (GDD) forms a new bypass pathway for the aqueous humor. It is a useful device for the management of intractable glaucoma as it drains the aqueous from the anterior chamber into the subconjunctival space. GDDs are of three types—setons, valved implant and nonvalved implant. Authors have described step-by-step surgical procedure of implantation of the implant and its early and late complications.
There are a number of factors which influence the outcome of IOL implantation. One of the most important factors is the correct calculation of power of IOL. Ultrasound has been used for measurement of ocular parameters for the calculation of IOL power for quite a long time. However, these calculations do not reach within 0.50 diopters of the target refraction in 25% of cases, and some of the eyes present significant refractive surprise. Recently, biometers using optical partial coherence interferometry or optical low coherence reflectometry have been introduced. These biometers are user-friendly and accurate. Mohan and Chakrabarti presented a detailed account of advances in the calculation of IOL power determination.
Cataract operation is the most common surgery performed worldwide. Several measures have been adopted to make it safe and improve its outcome even in complicated cases. Chapters like Custom Cataract Surgery, Astigmatism Management in Cataract Surgery, Posterior Capsular Rupture Recognition and Management, Femtosecond Laser-assisted Cataract Surgery in Posterior Polar Cataracts, Pseudoexfoliation Cataract: Management and Phacoemulsification in Subluxated Lenses are included in this volume for the benefit of young ophthalmic surgeons so that they may become more careful and meticulous in performing the surgery in difficult patients. It is not rare to witness loss of capsular support in cataract surgery. The surgeon cannot implant IOL in the bag. The scleral fixed IOL is the right answer in such a situation.
It has become a fashion to cite clinical trials extensively without clearly understanding their application in real-life situations. Lingam Gopal deserves compliments for discussing how to adopt the results of trials in the management of retinal vascular diseases.
Optical Coherence Tomography Angiography (OCTA) is a noninvasive, high resolution imaging technique that provides angiographic maps of retina and choroid to study the blood circulation. It can diagnose ischemia of choriocapillaris and choroidal neovascular membrane (CNVM). Since OCTA presents a 3D view of tissues, it can detect minor abnormalities of the retina and choroid. In a comprehensive chapter, Chaitra and colleagues have described principle and procedure of OCTA and discussed the findings in normal retina and common retinal diseases such as diabetic retinopathy, retinal vascular occlusions, CNVM and age-related macular degeneration. OCTA can also be used to evaluate inflammatory diseases of retina and choroid, and intraocular tumors.
The chapter on the role of spectral domain-optical coherence tomography (SD-OCT) in the evaluation of diabetic retinopathy highlights the importance of examination of vitreomacular interface and inner and outer layers of retina. A relationship between disruption of ellipsoid zone and visual acuity has been found.
In this volume, the readers can also derive benefit from interesting chapters on Necrotizing Retinopathies, Nyctalopia, Ocular Burns and Cerebral Angiography.
We know that in the past few decades tremendous progress has been made in all fields of ophthalmology. This volume presents information on some of the advances. Hopefully, the postgraduate students, residents and general ophthalmologists will utilize the knowledge effectively for the better care of their patients.
HV Nema
Nitin Nema
Acknowledgments
We are indebted to all contributors for submitting their chapters well in time in spite of their preoccupations and other commitments. Authors’ cooperation in correction of proofs and replacement of photographs is laudable.
Credit goes to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director) and Ms Chetna Malhotra Vohra (Associate Director–Content Strategy) for their interest in Recent Advances in Ophthalmology series. We appreciate the hard work of Ms Nikita Chauhan (Senior Development Editor) for elimination of plagiarism and staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi for nice production of the book.