蕭裕泉醫師眼科筆記

20140420第49次眼科地方醫學會 1.Ortho-K可以讓peripheral retina影像有點在前面，positive SA,可以抑制眼軸增長，瞳孔愈大，度數愈　　深、 抑制近視增長的效果愈好。 2.使用於對散瞳劑atropine無法忍受、近視持續進行、 可以使用。 3.配戴OK矯正度數愈多，產生愈多的spherical aberration 愈多 。 4.Aspherical SCL with positive SA的也可以抑制近視加深 。 5.OK直徑僅量接近角膜邊緣0.5mm。 6.自然的光線，也比較不會近視加深。 7.Scleral CL :像倒一碗水至眼睛上 。 8.Viscoat當成防火牆 。

Toric IOLs Off axis? Fixing a toric IOL that's malpositioned by Vanessa Caceres EyeWorld Contributing Writer Ophthalmic surgeons share pearls, perspectives T here's a starter question to ask if your patient has a toric IOL that is not at the right position postoperatively: Is the patient happy with his/her vision? "If their vision is 20/25 or perhaps even 20/40, I advise leaving it alone. There's no need to reposition their toric lens if they are happy," said Terry Kim, MD, professor of ophthalmology, Duke University Eye Center, Durham, N.C. "Many patients are happy with better, though not perfect, refractive outcomes," said Michael Y. Wong, MD, Princeton Eye Group, Princeton, N.J., and instructor, Rutgers Medical School, New Brunswick, N.J. However, if the patient is unhappy, there are a few choices to consider. First, consider the possible cause of his/her dissatisfaction. "If the patient is not happy, you have to go through a

Toric IOLs Measurement remains key to best toric IOL outcomes by Rich Daly EyeWorld Contributing Writer " D espite all this planning and preparation, one can still have uncontrollable intangibles and end up with residual, off-axis astigmatism. Just be prepared to handle these eventualities postoperatively …" – Sydney L. Tyson, MD Although many patients can benefit from toric lenses, surgeons have to take special care to ensure their fit and location A dhering to key measurement steps in toric lens implantation can keep both standard and challenging astigmatism patients on track. Although Sydney L. Tyson, MD, an attending surgeon at Wills Eye Hospital , Philadelphia , avoids implanting toric IOLs in eyes with highly irregular corneas for fear of inducing or worsening higher order aberrations, he does not limit toric lenses to patients with regular corneal astigmatism. "In general, I believe that maximizing the treatment

Impact of lens design and materials on cataract surgery by George H.H. Beiko, BM, BCh, FRCS(C) outcomes Analyzing the spectrum of light used for scotopic vision shows that blue light provides 35% of scotopic sensitivity. Source: George H.H. Beiko, BM, BCh, FRCS(C) Comparison of transmission of blue light in the natural crystalline lens and different current IOLs18 Source: George H.H. Beiko, BM, BCh, FRCS(C) S ynergy is the value and performance of any elements which, when combined, are greater than the sum of the separate individual parts. Achieving optical synergy in visual outcomes following cataract surgery is accomplished by selecting a high performance lens design produced with proven, high caliber materials. Proper lens selection has been shown to improve spherical aberration correction, chromatic aberration correction, light transmission, material clarity, as well as limit lens epitheli

The art of advanced technology IOLs Is this IOL centered? Angle kappa and multifocal IOLs by Richard Tipperman, MD Richard Tipperman, MD Almost every clinician has had the experience of seeing a patient with a multifocal IOL where the rings on the optic are "perfectly centered" referable to the pupil and yet the patient is unhappy with his/her visual function; another patient will have a multifocal IOL where the rings are clearly "decentered" in relation to the pupil yet the patient is very pleased. How can this be possible? Is one patient just "high maintenance" while the other is easygoing? A better explanation than "baseline personality" rephrases the question of "Is the IOL centered?" to "Is the IOL centered in reference to what?"         It is likely much more important that the IOL be centered in relation to the patient's true visual axis rather than the geometric center of the pupil. To u