蕭裕泉醫師眼科筆記

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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...

Using cataract surgery as a treatment for ocular hypertension ________________________________________ by Michelle Dalton EyeWorld Contributing Writer James D. Brandt, M.D. Steven L. Mansberger, M.D.           C ataract surgery can lower IOP in patients with ocular hypertension (OH), according to results from a large cohort study.1 Steven L. Mansberger, M.D., director, Glaucoma Services, Devers Eye Institute, Portland, Ore., and colleagues determined "someone who has early glaucoma or needs only 10-20% IOP lowering should be considered for cataract surgery," he said, but does stress the results are only applicable for those with OH, a point co-author James D. Brandt, M.D., professor of ophthalmology, and director, Glaucoma Service, University of California-Davis, reiterated. "We only evaluated OH. It is dangerous to extrapolate the findings of this study to those with glaucoma. It's a whole different population, es...