Refractive Lens Surgery I.H.Fine M.Packer R.S.Hoffman (Eds.) Editors I.Howard Fine Mark Packer Richard S.Hoffman Refractive Lens Surgery With 170 Figures,Mostly in Colour, and 11 Tables 123 Editors I.Howard Fine,MD Mark Packer,MD,FACS Richard S.Hoffman,MD Department ofOphthalmology Oregon Health & Science University 1550 Oak St.Suite 5 Eugene,Oregon 97401 USA This eBook does not include ancillary media that was packaged with the printed version of the book. ISBN-10 3-540-22716-4 Springer Berlin Heidelberg New York ISBN-13 978-3-540-22716-8 Springer Berlin Heidelberg New York Library ofCongress Control Number:2005924302 The use of general descriptive names, registered names,trademarks,etc.in this publication does not This work is subject to copyright. 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Desk editor:Martina Himberger,Heidelberg Production:ProEdit GmbH,Elke Beul-Göhringer, Heidelberg Springer is a part of Springer Science+ Cover design:Estudio Calamar,F.Steinen-Broo, Business Media Pau/Girona,Spain Typesetting and reproduction ofthe figures: springeronline.com AM-productions GmbH,Wiesloch © Springer-Verlag Berlin Heidelberg 2005 Printed on acid-free paper Printed in Germany 24/3151beu-göh 5 4 3 2 1 0 V Dedication for Refractive Lens Surgery The editors respectfully dedicate this book and those of us who were doubters have to the many pioneers of refractive surgery learned that lesson and as a result have who had the courage to operate on healthy enhanced the satisfaction we derive from eyes in order to enhance the quality of life our own careers. oftheir patients. They were right all along VII Preface The first recorded time a human lens was tion. Because of the changing spherical removed for the purpose of addressing a aberration in the lens, no matter what is refractive error was by an ophthalmologist done to the cornea as a refractive surgery named Fukala in 1890. We do not know modality,including the most sophisticated what type of criticism he experienced,but custom corneal shaping,functional vision we know that today he is a forgotten man in is going to be degraded by changing spher- ophthalmology. The introduction ofthis as ical aberration in the lens over time. a concept in the late 1980s by both Drs.Paul This coupled with the fact that higher Koch and Robert Osher’s manuscripts,re- myopes and hyperopes,patients with early sulted in considerable disdain and some cataracts,and presbyopes are not necessar- condemnation by some of their colleagues ily good candidates for LASIK has resulted and peers.At the time,refractive surgery in in a fresh look at lens-based refractive sur- the United States was limited to radial ker- gery. We have seen recent improvements in atotomy. With the development ofexcimer phakic IOL technology and utilization and lasers came a very marked change in the at- we ourselves have been increasingly moti- titude of eye surgeons internationally re- vated to work with lens related refractive garding the concept of invading “healthy” surgery modalities. tissue for refractive purposes and within a Our own work with power modulations, relatively short period oftime,LASIK was a the IOL Master,and wavefront technology firmly established procedure as were other IOLs has convinced us that lens-related re- modalities ofcorneal refractive surgery. fractive surgery can give superior results. However,we have come to recognize that Stephen Klyce, MD, the developer of corneal refractive surgery, and especially corneal topography has demonstrated, LASIK, has limitations. We have also using topographical and wavefront analysis learned much in the recent past about methods, that IOL intraocular optics are functional vision through the use of con- far superior to the optics of the most so- trast sensitivity and an analysis of higher phisticated, customized wavefront treated order optical aberrations. We have also cornea. We have also seen the development learned that the cornea has constant spher- of new lens technologies including im- ical aberration but the lens has changing proved multifocal IOLs, improved accom- spherical aberrations. In the young,the hu- modative IOLs, light adjustable IOLs, in- man lens compensates for the cornea’s pos- jectable IOLs, and a variety of other itive spherical aberration,but as we age the investigational IOL technologies that sug- changing spherical aberration within the gest unimaginable possibilities. Our own lens exacerbates corneal spherical aberra- results with the Array and Crystalens have VIII Preface been very encouraging as has our work delegation.My reliance on my two partners with bimanual micro-incision phacoemul- is evident throughout the book in the au- sification,which I believe has allowed us to thorship ofthe chapters we have produced. develop a refractive lens exchange tech- It is my belief that just as refractive lens nique that sets a new standard for safety exchange represents the future ofrefractive and efficacy. It is our belief that refractive surgery that my partners, Drs. Richard S. lens exchange is indeed not only the future Hoffman and Mark Packer, represent the of refractive surgery,but in many ways the new generation of leadership in anterior procedure that will become a mainstay of segment ophthalmic surgery. ophthalmology within the coming decades. A major task for any editor is delegation, and this book represents the ultimate in I.Howard Fine X Contents Chapter 14 Chapter 22 AcrySofReSTOR The Infiniti Vision System . . . . . . . . . . . 209 Pseudo-accommodative IOL . . . . . . . . . 137 Mark Packer,Richard S.Hoffman, Alireza Mirshahi,Evdoxia Terzi, I.Howard Fine Thomas Kohnen Chapter 23 Chapter 15 The Millennium . . . . . . . . . . . . . . . . . . . . 213 The Tecnis Multifocal IOL . . . . . . . . . . . 145 Rosa Braga-Mele,Terrence Devine, Mark Packer,I.Howard Fine, Mark Packer Richard S.Hoffman Chapter 24 Chapter 16 The Staar Sonic Wave. . . . . . . . . . . . . . . . 221 Blue-Light–Filtering Intraocular Richard S.Hoffman,I.Howard Fine, Lenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Mark Packer Robert J.Cionni Chapter 25 Chapter 17 AMO Sovereign The Light–Adjustable Lens. . . . . . . . . . . 161 with WhiteStar Technology . . . . . . . . . . 227 Richard S.Hoffman,I.Howard Fine, Richard S.Hoffman,I.Howard Fine, Mark Packer Mark Packer Chapter 18 Chapter 26 Injectable Polymer. . . . . . . . . . . . . . . . . . 173 Refractive Lens Exchange in High Myopia: Sverker Norrby Weighing the Risks. . . . . . . . . . . . . . . . . . 233 Mark Packer,I.Howard Fine, Chapter 19 Richard S.Hoffman The Vision Membrane. . . . . . . . . . . . . . . 187 Lee Nordan,Mike Morris Chapter 27 Conclusion:The Future Chapter 20 ofRefractive Lens Surgery. . . . . . . . . . . 237 Bimanual Ultrasound Mark Packer,I.Howard Fine, Phacoemulsification . . . . . . . . . . . . . . . . 193 Richard S.Hoffman Mark Packer,I.Howard Fine, Richard S.Hoffman Subject Index. . . . . . . . . . . . . . . . . . . . . . . 239 Chapter 21 Low Ultrasound Microincision Cataract Surgery. . . . . . . . . . . . . . . . . . . . 199 Jorge L.Alio,Ahmed Galal, Jose-Luis Rodriguez Prats, Mohamed Ramzy IX Contents Chapter 1 Chapter 8 The Crystalline Lens as a Target Correction ofKeratometric Astigmatism: for Refractive Surgery. . . . . . . . . . . . . . . 1 AcrySofToric IOL. . . . . . . . . . . . . . . . . . . 71 Mark Packer,I.Howard Fine, Stephen S.Lane Richard S.Hoffman Chapter 9 Chapter 2 Wavefront Technology Refractive Lens Exchange ofSpherical Aberration . . . . . . . . . . . . . 79 as a Refractive Surgery Modality . . . . . 3 Mark Packer,I.Howard Fine, Richard S.Hoffman,I.Howard Fine, Richard S.Hoffman Mark Packer Chapter 10 Chapter 3 The Eyeonics Crystalens. . . . . . . . . . . . . 87 Biometry for Refractive Lens Surgery. . 11 Steven J.Dell Mark Packer,I.Howard Fine, Richard S.Hoffman Chapter 11 Presbyopia – Cataract Surgery Chapter 4 with Implantation ofthe Intraocular Lens Power Calculations: Accommodative Posterior Correction ofDefocus. . . . . . . . . . . . . . . 21 Chamber Lens 1CU. . . . . . . . . . . . . . . . . . 99 Jack T.Holladay Nhung X.Nguyen, Achim Langenbucher, Chapter 5 Berthold Seitz,M.Küchle IOL Calculations Following Keratorefractive Surgery. . . . . . . . . . . . . 39 Chapter 12 Douglas D.Koch,Li Wang Synchrony IOL. . . . . . . . . . . . . . . . . . . . . . 113 H.Burkhard Dick, Mana Tehrani, Chapter 6 Luis G.Vargas,Stephen D.McLeod Correction ofKeratometric Astigmatism: Incisional Surgery . . . . . . . . . . . . . . . . . . 49 Chapter 13 Louis D.Nichamin Sarfarazi Elliptical Accommodative Intraocular Lens. . . . . . . . . . . . . . . . . . . . 123 Chapter 7 Faezeh Mona Sarfarazi STAAR Toric IOL . . . . . . . . . . . . . . . . . . . 59 Stephen Bylsma XI Contributors Jorge L.Alio,MD,PhD Richard S.Hoffman,MD Inst Oftalmologico de Alicante Department ofOphthalmology Avda Denia 111 Oregon Health & Science University Alicante 03015,Spain 1550 Oak St.Suite 5 Eugene,Oregon 97401,USA Rosa Braga-Mele,MD,FRCSC 200-245 Danforth Ave. Jack Holladay,MD Toronto,Ontario M4K 1N2,Canada 5108 Braeburn Drive Bellaire,TX 77401-4902,USA Stephen S.Bylsma,MD Shepherd Eye Center John Hunkeler,MD 1414 E Main Street Hunkeler Eye Institute,P.A. Santa Maria,CA 93454,USA 4321 Washington,Suite 6000 Kansas City,MO 64111-5905,USA Robert J.Cionni,MD Cincinnati Eye Institute Douglas Koch,MD 10494 Montgomery Rd Cullen Eye Institute Cincinnati,OH 45242,USA 6565 Fannin,Suite NC205 Houston,TX 77030,USA Steven J.Dell,MD 1700 S Mopac Thomas Kohnen,MD Austin,TX 78746-7572,USA Johann Wolfgang Goethe-University Department ofOphthalmology H.Burkhard Dick,MD,PhD Theodor-Stern Kai 7 Department ofOphthalmology 60590 Frankfurt,Germany Johannes Gutenberg-University Langenbeckstraße 1 Stephen S.Lane,MD 55131 Mainz,Germany Associated Eye Care,Ltd. 232 North Main Street I.Howard Fine,MD Stillwater,MN 55082,USA Department ofOphthalmology Oregon Health & Science University Richard L.Lindstrom,MD 1550 Oak St.Suite 5 Minnesota Eye Consultants,P.A. Eugene,Oregon 97401,USA 710 E.24th Street,Suite 106 Minneapolis,MN 55404,USA