The authors of this book are busy practical men with no particular barrow to push. The text of the book includes a comprehensive review of all aspects of intraocular lens surgery including details of the design, optics chem­ istry and sterilization of intraocular lenses. Its value is enhanced by excellent illustrations and extensive tabulated references to the litera­ ture. Accounts of patient acceptability are balanced against candid discus­ sion of complications and their management. The historical introduction recalls that in the early stages of develop­ ment of the art, over a period of 10 years, two dozen different lens designs were proposed, most claiming elimination of problems which had arisen with their predecessors. Eventually nearly all disappeared from the scene. In an age where every cataract surgeon has to determine a personal position on intraocular lens implantation the author's reflections on these matters are timely. Intraocular lenses are neither a miracle nor a menace, provided that personal decisions and preferences are carefully thought through and put into practice upon the basis of known facts and not upon the basis of fickle fashion and fad. This book provides a background upon which the reader can eva­ luate in his own mind the validity of information provided by the manufacturers of various lens designs.



Inhalt

I History.- I. Posterior Chamber Lenses.- II. Anterior Chamber Lenses.- III. Toward the Modern Implant Lenses.- II The Classic Modern Lens.- I. Design and Fixating Principles of the Classic Lens Models.- A. Iris Supported Lenses.- B. Iridocapsular and Capsular Supported Lenses.- C. Angle Supported Lenses.- II. General Nomenclature.- III Materials, Manufacture, and Sterilization.- § 1 Basic Materials.- I. Plastics for Intraocular Use.- A. Polymethylmethacrylate.- 1. Synthesis of the Monomer.- 2. Polymerization.- B. Polyamides or Nylons.- 1. Nylon 6.- 2. Nylon 6/6.- 3. Properties of Polyamides.- 4. Nylon Degradation in vivo.- C. Polypropylene.- II. The Metals.- A. Platinum.- B. Titanium.- C. Stainless steel.- § 2 Manufacture.- A. Rayner.- B. Mocher.- §3 Sterilization.- IV The Optics of Intraocular Lenses.- I. The Optical Quality of Polymethylmethacrylate Lenses.- II. The Dioptric Power of Human Crystallin.- III. The Pseudophakos as a Substitute for the Crystalline Lens.- IV. Determination of Implant Lens Power.- A. The 1.25 Diopter Rule.- B. Calculating the Lens Power from Biometrie Data.- V. Determination of the Iseikonic Lens Power.- VI. Practical Considerations on the Proper Selection of the Implant Power.- V Pre-, Per-, and Postoperative Management.- I. Preoperative Management.- A. Clean and Aseptic Surgery.- B. The Pupil.- C. General or Local Anesthesia.- D. Visibility.- E. Preparation of the Lens.- F. Obtaining a "Soft" Eye.- 1. Diuretics and Osmotic Agents.- 2. Ocular Massage.- 3. Separation of the Eyelids.- 4. Scleral Ring.- 5. Pars Plana Vitreous Tap-Vitrectomy.- 6. Anesthesia: Local and General.- II. Peroperative Management.- A. Incision.- B. Cataract Extraction.- 1. Intracapsular Cataract Extraction.- 2. Extracapsular Cataract Extraction.- a. Step I: Capsulotomy-Capsulectomy.- b. Step II: Removal of the Nucleus.- c. Step III: Evacuation of Cortical Remnants.- C. Common Points in Lens Implantation.- 1. After Intracapsular Cataract Extraction.- 2. After Extracapsular Cataract Extraction.- 3. Glides and Sleeves.- 4. Pupil Constriction.- 5. Iridectomies.- 6. Finishing Touches.- D. Wound Closure and Astigmatism.- III. Postoperative Management.- A. Postoperative Care.- B. Postoperative Complications.- 1. Shallow and Flat Anterior Chamber.- 2. Subluxation and Luxation.- 3. Decentration.- 4. Secondary Procedures for Lens Remnants.- 5. Incision of the Posterior Capsule and Secondary Membranes.- 6. Lens Removal.- IV. Stabilization of Implants by Sutures.- 1. Alpar's Approach.- 2. Simcoe's Approach.- 3. McCannel-Binkhorst Suture.- 4. The Strampelli Thread.- VI The Iris Supported Lenses.- §1 The Iris Clip Lens.- I. Introduction to the Lens and Its Evolution.- A. Binkhorst's Design Changes.- B. Binkhorst's Changes in Loop Orientation and Additional Fixation Aids.- C. Modifications of the Iris Clip Lens by Other Surgeons.- II. Implantation Techniques.- A. Binkhorst's Technique.- 1. Vertical Positioning of the Lens.- 2. Transiridectomy Suturing.- B. Other Techniques.- 1. The "Closed Chamber" Technique.- 2. Horizontal Positioning of the Lens.- 3. Modified Suturing Techniques.- III. Twenty Years of Experience with the Iris Clip Lens: 1958-1978.- A. The Developmental Period: Binkhorst's Experience, 1958-1971.- 1. Secondary Implantations: Binkhorst's First 70 Cases.- 2. Primary Implantations by Binkhorst from 1961 to 1971.- a. The First Primary Implantations of Iris Clip Lenses.- b. The Survey of J. Pearce.- c. Nordlohne's Survey of Binkhorst's Patients.- 3. Discussion and Conclusions about Binkhorst's Use of Iris Clip Lenses after ICCE during the Developmental Period.- a. The Materials Used.- b. Tissue Reaction.- c. Secondary Membranes.- d. Glaucoma.- e. Cystoid Macular Edema.- f. Retinal Detachment.- g. Hemorrhage.- h. Dislocation and Endothelial Corneal Dystrophy.- 1) The Problem of Dislocation.- - Types of Dislocation.- - Dislocation Prevention.- 2) The Problem of Endothelial Corneal Dystrophy.- - Analysis of Factors Contributing to ECD.- - Endothelial Corneal Dystrophy Prevention.- 4. Other Reports on the Iris Clip Lens after ICCE during the Developmental Period.- a. Results of Different Surgeons in 321 Cases.- b. Nordlohne's Survey of 485 Iris Clip Lenses Implantations by J. Worst.- 5. Conclusions for the Developmental Period.- B. The Current Situation: Recent Data on the Use of the Iris Clip Lens after Intracapsular Cataract Extraction.- 1. The Data Published by J. Draeger, K. Schott, and N.S. Jaffe.- 2. Conclusion.- §2 The Copeland Lens.- I. Introduction.- II. Implantation Techniques.- A. The Open-Sky Technique.- B. The Formed Chamber Technique.- III. Survey of the Early Results.- A. Jaffe's Series.- B. The Miami Series.- IV. Recent Studies.- A. Osher's Study.- B. Other Studies on the Copeland Lens.- 1. Snider's and Taylor's Series: 595 Cases.- 2. Benjamin's. Sherman's, and Gentri's Series: 101 Cases 209 V. Conclusions.- §3 Medallion Lens.- I. Introduction.- II. Implantation Techniques.- A. The Medallion Lens.- B. The Slotted Medallion Lens.- III. Development of the Medallion Lens.- A. Worst's Early Results.- B. The Developmental Period.- 1. Introduction.- 2. Worst's Modifications of the Medallion Lens.- a. The Medallion Platinum Clip Lens.- b. The Single Loop Medallion Lens.- 3. Other Lens Designs by Worst.- IV. The Current Situation: The Data Published by R. Drews, M.C. Kraff, and H. Lieberman.- V. Conclusion.- §4 The Sputnik Lens.- I. Introduction.- II. Implantation Techniques.- A. The Open-Sky Technique.- B. The Formed Chamber Technique.- III. Results.- A. Fyodorov's Series.- B. Galin's Series.- C. Kwitko's Series.- IV. Conclusion.- §5 Other Lens Designs.- I. The Krasnov Extrapupillary Iris Lens.- II. The Sachar Lens.- III. The Boberg-Ans Lens.- IV. The Rainin Anchor Lens.- V. A Soft Iris Supported Lens.- VI. The Glass Intraocular Lens.- VII. The Anis Lens.- VIII. The Iris Claw Lens.- IX. The Severin Lenses.- General Conclusion on Iris Supported Lenses.- VII Iridocapsular and Capsular Supported Lenses.- I. Advantages of Lens Implantation after Extracapsular Cataract Extraction.- A. Practical Considerations.- B. Clinical Observations.- C. Theoretical Considerations: The Barrier Deprivation Syndr..- II. The Mechanism of Capsular Fixation.- III. Lens Styles Used after Extracapsular Cataract Extraction.- § 1 Iridocapsular Lenses.- I. The Binkhorst Two-Loop Lens.- A. Binkhorst's Technique.- 1. Preliminary Steps.- 2. Implantation Technique.- 3. Postoperative Measures.- 4. Modifications of Binkhorst's Technique.- B. Binkhorst's Results.- C. Results of the Authors.- D. Results from Other S…

Titel
Lens Implantation
Untertitel
30 Years of Progress
EAN
9789400980181
Format
E-Book (pdf)
Genre
Veröffentlichung
06.12.2012
Digitaler Kopierschutz
Wasserzeichen
Dateigrösse
45.95 MB
Anzahl Seiten
622