A concise review and comprehensive guide to improving cataract surgery outcomes

Significant advances have been made in refractive surgery in the last decade. Eye surgeons today can leverage many cutting-edge intraocular lens (IOL) technologies such as multifocal, extended depth of field, toric, accommodating, and aspheric. Concurrent innovations including optics, phacoemulsification, superior keratometry and biometry, and posterior cornea evaluation have resulted in improved cataract surgery outcomes. Recent advances in the diagnosis and treatment of cataracts have dramatically improved patient satisfaction following cataract surgery, yet common and rare complications still occur such as dry eye, endophthalmitis, and retinal detachment. Furthermore, only 80% of cataract surgery procedures bring patients to within 0.5 diopters of their needed refraction.

Optimizing Suboptimal Results Following Cataract Surgery: Refractive and Non-Refractive Management presents the latest techniques for achieving optimal results and overcoming complications in cataract surgery. Internationally renowned ophthalmic surgery pioneers Priya Narang and William Trattler have created an unparalleled guide to overcoming complex cases and residual refractive errors. The book starts with six chapters on suboptimal causes and considerations, followed by dedicated sections covering refractive and non-refractive enhancements. The fourth section features chapters on keratoconus, cystoid macular edema, endophthalmitis, toxic anterior segment syndrome, and vitritis, as well as intraoperative aberrometry, futuristic approaches and advancements, and telescopic IOLs.

Key Highlights

• Refractive enhancement procedures including corneal-based procedures such as astigmatic keratotomy, LASIK, PRK, and SMILE; IOL exchange; piggyback IOL; toric IOL; and premium IOLs and associated problems
• Nonrefractive enhancement procedures including dysphotopsias and surgical management, bullous keratopathy and endothelial keratoplasty, complex IOL issues such as malpositioned IOL and capsular bag, and posterior capsular rupture and IOL lens implantation
• Practical tips and steps to prevent and manage undesired outcomes
• ۳۰ surgical videos posted online highlight a diverse array of complex cases and technical advances to help prevent suboptimal results

Ophthalmologists, ophthalmology residents, fellows, and subspecialists will greatly benefit from the significant pearls and knowledge presented in this indispensable cataract surgery resource.

Contents

۱ Overview of the Causes of Suboptimal Outcomes Following Cataract Surgery: Role of Preoperative Screening and Adequate Counseling
۲ Tear Film and Corneal Disorders
۳ Postrefractive Intraocular Lens Power Calculation: Choosing the Right Nomogram
۴ Residual Refractive Error
۵ Posterior Corneal Astigmatism: Basics and Clinical Implications
۶ Considerations in Cataract Surgery Following Postrefractive Error Correction
۷ Corneal-Based Procedures: Astigmatic Keratotomy, LASIK, PRK, and SMILE
۸ Intraocular Lens Exchange
۹ Piggyback Intraocular Lens
۱۰ Toric Intraocular Lens
۱۱ Premium Intraocular Lenses and Associated Problems
۱۲ Dysphotopsias and Surgical Management
۱۳ Bullous Keratopathy and Endothelial Keratoplasty
۱۴ Malpositioned Intraocular Lens and Capsular Bag: Intraocular Lens Complex Issues
۱۵ Posterior Capsular Rupture and Intraocular Lens Implantation
۱۶ Miloop: Micro-Interventional, Phaco-Free, Lens Fragmentation
۱۷ Keratoconus and Cataract Surgery
۱۸ Bilensectomy (Phakic IOL Explantation with Coincidental Cataract Surgery and IOL Implantation)
۱۹ Cystoid Macular Edema and Management
۲۰ Endophthalmitis, Toxic Anterior Segment Syndrome, and Vitritis
۲۱ Intraoperative Aberrometry
۲۲ Futuristic Approach and Advancements
۲۳ Telescopic Intraocular Lenses

Video Contents

Video 8.1 Intraocular lens (IOL) exchange for broken haptic.
Video 8.2 Removal of opacified memory lens.
Video 8.3 Intraocular lens (IOL) exchange in phimotic capsule.
Video 14.1 L-shaped pocket incision and subluxated one-piece intraocular lens (IOL).
Video 14.2 Subluxated one-piece foldable intraocular lens (IOL) with single-pass four-throw (SFT) pupilloplasty.
Video 14.3 Subluxated intraocular lens (IOL) with broken haptics.
Video 14.4 Subluxated anterior chamber intraocular lens (ACIOL) with haptic protrusion in the sclera.
Video 14.5 Malpositioned three-piece intraocular lens (IOL) in sulcus.
Video 14.6 Dropped intraocular lens (IOL).
Video 15.1 Sulcus placement of an intraocular lens (IOL) in posterior capsule rupture.
Video 15.2 Posterior assisted levitation and intraocular lens (IOL) scaffold.
Video 15.3 Sleeveless phacotip assisted levitation (SPAL) with intraocular lens (IOL) scaffold.
Video 15.4 Refractive glued intraocular lens (IOL) exchange.
Video 15.5 Triumvirate technique.
Video 15.6 Glued intraocular lens (IOL) scaffold.
Video 15.7 Gluing the intraocular lens (IOL) beneath the subluxated cataractous lens.
Video 15.8 Glued intraocular lens (IOL) scaffold for Soemmering’s ring.
Video 15.9 Phimotic capsular bag–intraocular lens (IOL) complex dislocation.
Video 15.10 L-shaped scleral incision with refractive intraocular lens (IOL) exchange with Soemmering’s ring and glued IOL.
Video 15.11 No-assistant technique for glued intraocular lens (IOL).
Video 15.12 Handshake technique for glued intraocular lens.
Video 15.13 Complications of glued intraocular lens (IOL).
Video 18.1 Bilensectomy: Kelman’s intraocular lens (IOL) explantation.
Video 18.2 Bilensectomy: Artisan’s intraocular lens (IOL) explantation.
Video 18.3 Implantable contact lens (IPCL) explantation.
Video 22.1 Demonstration of the mechanism of action of light-adjustable intraocular lens.
Video 23.1 Superman returns.