In the past decade we have seen the convergence of refractive surgery with cataract surgery, which makes sense because the most commonly performed refractive procedure is phacoemulsification with IOL implantation. Corneal-based refractive surgery has e…
Paul Dougherty describes his experience with LASIK in his 30s and then again at age 47, at the onset of presbyopia.I chuckled reading Paul’s description of multiple refractions and using trial lenses on his drive down to Tijuana. I think that this behavior would be common for many of us who do this for a living.
Corneal ectasia is an important corneal pathology, and like so many other diseases, its diagnosis and treatment are currently evolving rapidly. Corneal ectasia includes keratoconus, pellucid marginal degeneration, posterior keratoconus and post-laser r…
IOL implantation requires proper seating of the IOL within the lens capsular bag, with good IOL centration and without any contact with the adjacent tissues such as the iris. Repeated mechanical rubbing of the IOL against the iris tissue can result in secondary inflammation such as iritis, synechiae formation, pupillary distortion, secondary glaucoma and even macular edema with decreased postoperative vision. The indications for an IOL exchange include: Incorrect IOL power calculations preoperatively. Optical aberrations interfering with the patient’s daily activities. Subluxated and dislocated IOL. IOL opacification causing visual symptoms. Damaged IOL with ongoing secondary adjacent tissue damage and/or visual symptoms.In this column, I describe the surgical technique of IOL exchange in a referred patient, with IOL optic damage during surgery, and present some surgical pearls for IOL exchange.
(MedPage Today) — Doctors need to take the lead, says Peter Ubel, MD
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