ESSENTIALS IN OPHTHALMOLOGY: Cataract and Refractive Surgery.
T. Kohnen · D. D. Koch (Eds.)
ESSENTIALS IN OPHTHALMOLOGY G. K. Krieglstein · R. N. Weinreb Series Editors
Glaucoma
Cataract and Refractive Surgery Uveitis and Immunological Disorders Vitreo-retinal Surgery
Medical Retina
Oculoplastics and Orbit Paediatric Ophthalmology, Neuro-ophthalmology, Genetics Cornea and External Eye Disease
Editors Thomas Kohnen Douglas D. Koch
With 126 Figures, Mostly in Colour, and 37 Tables
Cataract
and Refractive Surgery
123
Series Editors
Günther K. Krieglstein,MD Professor and Chairman Department of Ophthalmology University of Cologne
Joseph-Stelzmann-Straße 9 50931 Cologne
Germany
Robert N. Weinreb, MD Professor and Director Hamilton Glaucoma Center
Department of Ophthalmology – 0946 University of California at San Diego 9500 Gilman Drive
La Jolla, CA 92093-0946 USA
ISBN 3-540-20046-0
Springer Verlag Berlin Heidelberg New York
Volume Editors Thomas Kohnen,MD Professor of Ophthalmology
Johann-Wolfgang-Goethe Universität Klinik für Augenheilkunde
Theodor-Stern-Kai 7 60590 Frankfurt Germany
Douglas D. Koch, MD
Professor and the Allen, Mosbacher, and Law Chair in Ophthalmology Baylor College of Medicine Cullen Eye Institute 6565 Fannin, Suite NC 205 Houston, TX 77030 USA
ISSN 1612-3212
Library of Congress Control Number: 2004105920
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Essentials in Ophthalmology is a new review se- ries covering all of ophthalmology categorized in eight subspecialties. It will be published quar- terly; thus each subspecialty will be reviewed biannually.
Given the multiplicity of medical publica- tions already available, why is a new series needed? Consider that the half-life of medical knowledge is estimated to be around 5 years.
Moreover, it can be as long as 8 years between the description of a medical innovation in a peer-reviewed scientific journal and publica- tion in a medical textbook.A series that narrows this time span between journal and textbook would provide a more rapid and efficient trans- fer of medical knowledge into clinical practice, and enhance care of our patients.
For the series, each subspecialty volume comprises 10–20 chapters selected by two dis- tinguished editors and written by international- ly renowned specialists. The selection of these contributions is based more on recent and note-
worthy advances in the subspecialty than on systematic completeness. Each article is struc- tured in a standardized format and length, with citations for additional reading and an appro- priate number of illustrations to enhance im- portant points. Since every subspecialty volume is issued in a recurring sequence during the 2-year cycle, the reader has the opportunity to focus on the progress in a particular subspecial- ty or to be updated on the whole field. The clin- ical relevance of all material presented will be well established, so application to clinical prac- tice can be made with confidence.
This new series will earn space on the book- shelves of those ophthalmologists who seek to maintain the timeliness and relevance of their clinical practice.
G. K. Krieglstein R. N. Weinreb Series Editors
Foreword
This second volume in the Essentials in Ophthalmology series provides detailed and concise updates of the major topics in cataract and refractive surgery. Because of the remark- able growth of these two subspecialties, our challenge was to highlight new advances, with the primary emphasis on clinical applications.
The section on cataracts calls attention to recent progress in surgical techniques and the man- agement of complications. Topics include new anaesthesia and small incision techniques, new devices (ophthalmic viscosurgical devices and intraocular lenses), prevention and manage- ment of complications and the treatment of dif- ficult cases, such as mature, uveitic and paedi- atric cataracts.
As refractive surgery now encompasses an in- creasing array of procedures, the book covers excimer laser surface and lamellar procedures, incisional corneal surgery and the use of in- traocular implants to correct refractive errors.
Particular emphasis is placed on topics related to quality of vision, such as wavefront technolo- gy, measuring quality of vision and issues in
pupil measurement. We believe that these issues will be of growing importance as refractive sur- gical techniques are refined. Interestingly, many of the topics in this section are also pertinent to cataract surgery, reflecting the merging of tech- nologies that is occurring in these two major ophthalmic subspecialties.
The goal of the editors of this book has been to provide up-to-date, clinically relevant overviews in these fields and to highlight the most inter- esting areas of research and controversy. This was only possible with the support of our many outstanding authors. We truly appreciate the thought, time and care they put into their chap- ters. We would also like to thank the series edi- tors for giving us the opportunity to do the book, Springer for its excellent work on all as- pects of preparing it and our wives, Eva-Maria and Marcia, for their wonderful support during its realization.
Thomas Kohnen Douglas D. Koch
Preface
Chapter 1
Topical and Intracameral Anaesthesia for Cataract Surgery
Roberto Bellucci, Simonetta Morselli
1.1 Introduction . . . 1
1.1.1 Foreword . . . 1
1.1.2 History . . . 1
1.1.3 Definitions . . . 2
1.2 Bases of Topical/Intracameral Anaesthesia in Cataract Surgery . . . 2
1.2.1 Physiological Bases . . . 2
1.2.2 Pharmacological Bases . . . 2
1.2.3 Surgical Bases . . . 3
1.3 Drugs Employed . . . 3
1.3.1 Topical Anaesthetic Drugs . . . 3
1.3.2 Ester-Bound Compounds . . . 4
1.3.3 Amide-Bound Compounds . . . 4
1.3.4 Influence of Formulation . . . 5
1.4 Routes of Administration . . . 6
1.4.1 Eyedrop Instillations . . . 6
1.4.2 Gel Application . . . 7
1.4.3 Drug-Soaked Sponges . . . 8
1.4.4 Intracameral Irrigations . . . 8
1.4.5 Viscoelastic-Borne Anaesthesia . . . . 9
1.5 Preferred Procedures . . . 9
1.5.1 Patient Selection and Counselling . . 9
1.5.2 Surgery Adaptation . . . 9
1.5.3 Management of Complications . . . . 10
1.5.4 Postoperative Instructions . . . 10
1.6 Clinical Experience . . . 10
1.6.1 Topical Anaesthesia . . . 10
1.6.2 Intracameral Anaesthesia . . . 11
1.7 No Anaesthesia Cataract Surgery . . . 12
1.8 Current Recommendations . . . 12
1.8.1 Treatment Schedule . . . 12
1.8.2 Drug Selection . . . 13
1.9 Conclusions . . . 14
References . . . 14
Chapter 2 Surgical Techniques for Small Incision Cataract Surgery I. Howard Fine, Mark Packer, Richard S. Hoffman 2.1 Introduction . . . 19
2.2 Wound Construction and Architecture . . . 19
2.3 Continuous Curvilinear Capsulorhexis . . . 22
2.4 Hydrodissection and Hydrodelineation . . . 24
2.4.1 Cortical Cleaving Hydrodissection . . . 24
2.4.2 Hydrodelineation . . . 24
2.5 Nucleofractis Techniques . . . 25
2.5.1 Divide and Conquer Technique . . . . 26
2.5.2 Phaco Fracture Technique . . . 26
2.5.3 Chip and Flip Technique . . . 27
2.5.4 Crack and Flip Technique . . . 27
2.5.5 Phaco Chop . . . 28
2.5.6 Choo Choo Chop and Flip . . . 28
2.5.7 Laser Phacoemulsification . . . 32
2.5.8 Bimanual Ultrasound Phacoemulsification . . . 33
2.6 Conclusion . . . 34
References . . . 34
Chapter 3 Ophthalmic Viscosurgical Devices Steve A. Arshinoff 3.1 Introduction. . . 37
3.2 History . . . 38
3.3 Physical Properties of OVDs . . . 39
3.4 Generic or Proprietary Nomenclature . . . 40
Contents
Cataract Surgery
3.5 Currently Marketed Polymers . . . 40
3.5.1 Sodium Hyaluronates . . . 40
3.5.2 Chondroitin Sulphate . . . 42
3.5.3 Hydroxypropylmethylcellulose (HPMC) . . . 43
3.6 Polymers no Longer Marketed as OVDs . . . 43
3.6.1 Polyacrylamide . . . 43
3.6.2 Collagen IV . . . 43
3.7 The Physical (Rheologic) Properties of OVDs and Their Measurement . . 44
3.7.1 Viscosity (Dynamic) . . . 44
3.7.2 Plasticity . . . 44
3.7.3 Pseudoplasticity . . . 44
3.7.4 Elasticity . . . 45
3.7.5 Rigidity . . . 46
3.7.6 Cohesion and Dispersion . . . 46
3.8 Important Viscoelastic Rheologic Properties in the Various Steps of Cataract Surgery . . . 47
3.9 Choosing Viscoelastics for Specific Procedures . . . 49
3.9.1 Higher-Viscosity Cohesives . . . 49
3.9.2 Lower-Viscosity Dispersives . . . 50
3.10 The Viscoelastic Soft Shell Technique . . . 50
3.10.1 Background and Rationale . . . 50
3.10.2 The Dispersive-Cohesive Viscoelastic Soft Shell Technique . . 52
3.10.3 Method . . . 52
3.10.4 Using the Soft Shell Technique . . . 54
3.10.5 Application of the Soft Shell Technique to specific problems . . . . 55
3.11 Viscoadaptives – Healon5 . . . 56
3.11.1 Development . . . 56
3.11.1 Viscoadaptive Use in Complications 58 3.11.2 The Ultimate Soft Shell Technique . . 58
3.11.3 Removal of Viscoadaptives . . . 59
3.12 Conclusion . . . 60
References . . . 61
Chapter 4 Foldable Intraocular Lenses Liliana Werner, Nick Mamalis 4.1 Introduction and Brief Overview of Biomaterials Used for the Manufacture of Foldable Intraocular Lenses . . . 63
4.2 Silicone Intraocular Lenses . . . 64
4.2.1 Plate Intraocular Lenses . . . 64
4.2.2 Three-Piece Intraocular Lenses . . . . 65
4.3 Acrylic Intraocular Lenses . . . 66
4.3.1 Hydrophobic Acrylic Intraocular Lenses . . . 66
4.3.2 Hydrophilic Acrylic (Hydrogel) Intraocular Lenses . . . 70
4.4 Specialized Foldable Intraocular Lenses . . . 73
4.4.1 Multifocal Intraocular Lenses . . . 73
4.4.2 Toric Intraocular Lenses . . . 74
4.4.3 Aspheric Intraocular Lenses . . . 75
4.4.4 Intraocular Lenses with Special Blockers (Blue Blocker) . . . 76
4.4.5 Accommodative Intraocular Lenses . . . 76
4.4.6 Intraocular Lenses for Very Small Incisions . . . 78
4.4.7 Adjustable Power Intraocular Lenses . . . 80
4.5 Summary . . . 81
References . . . 82
Chapter 5 “Accommodative” IOLs Oliver Findl 5.1 Introduction . . . 85
5.1.1 Background . . . 85
5.1.2 Apparent Accommodation or Depth of Field . . . 86
5.1.3 Focus Shift Principle . . . 86
5.1.4 Clinical Assessment . . . 87
5.1.5 Accommodative IOLs . . . 89
5.1.6 Lens Refilling . . . 92
5.2 Clinical Experience with Available IOLs . . . 92
5.2.1 Conventional IOLs . . . 92
5.2.2 Accommodative IOLs . . . 93
5.3 Current Clinical Practice and Recommendations . . . 96
References . . . 98
Chapter 6 Prevention of Posterior Capsule Opacification Rupert M. Menapace 6.1 Definition, Types and Natural Behaviour of “After-Cataract” . . . 101 X Contents
6.2 Quantification of After-Cataract . . . 105
6.3 Prevention of After-Cataract . . . 105
6.3.1 Removing LEC from the Equator to Reduce the Proliferative Potential 105 6.3.2 Erecting Mechanical Barriers to Prevent LEC Migration . . . 106
6.4 Rationale for Investigating Alternatives: “Optic Edge Barrier Failures”. . . 111
6.4.4 Factors Influencing Fibrotic After-Cataract Formation . . . 114
6.4.5 The Role of Optic Material . . . 115
6.4.6 The Role of Patient Age . . . 115
6.4.7 Alternatives to the Sharp-Edged Optic . . . 116
References . . . 120
Chapter 7 Management of the Mature Cataract Samuel Masket 7.1 Introduction . . . 123
7.2 Cortical (Intumescent) Mature Cataracts . . . 125
7.3 What to Do When Things Go Wrong 128 7.4 The Nuclear Mature (Brunescent) Cataract . . . 128
7.5 Surgical Management . . . 129
References . . . 131
Chapter 8 The Treatment of Uveitic Cataract Arnd Heiligenhaus, Carsten Heinz, Matthias Becker 8.1 Introduction . . . 133
8.2 Basics for Cataract Formation in Uveitis . . . 133
8.3 Basics for the Consideration of IOL Implantation . . . 134
8.3.1 Uveal Biocompatibility . . . 134
8.3.2 Capsular Biocompatibility . . . 135
8.4 Patient Selection . . . 135
8.4.1 Aetiology of Uveitis . . . 135
8.4.2 Indications and Contraindications in Cataract Surgery . . . 135
8.5 Timing of Surgery and Preoperative Management . . . . 136
8.5.1 Timing of Surgery . . . 136
8.5.2 Preoperative Anti-inflammatory Medication . . . 136
8.6 Surgery . . . 137
8.6.1 Intraoperative Medication . . . 137
8.6.2 Approaches to Cataract Surgery . . . . 137
8.7 Extracapsular Cataract Extraction . . 138
8.8 Phacoemulsification . . . 138
8.9 Lensectomy . . . 139
8.9.1 Pars Plana Approach to Lensectomy – Anterior Vitrectomy . . 139
8.9.2 Limbal Approach to Lensectomy – Anterior Vitrectomy . . . 139
8.10 IOL Implantation . . . 140
8.10.1 General Concerns . . . 140
8.10.2 Indications and Contraindications . . 140
8.10.3 Placement of the Intraocular Lenses . . . 140
8.10.4 IOL Material . . . 141
8.10.5 IOL Design . . . 141
8.10.6 IOL Explantation . . . 141
8.11 Combined Vitrectomy . . . 142
8.11.1 Anterior Vitrectomy . . . 142
8.11.2 Pars Plana Vitrectomy (PPV) . . . 142
8.12 Typical Intraoperative Complications and Their Management . . . 143
8.12.1 Band Keratopathy . . . 143
8.12.2 Synechiae . . . 143
8.12.3 Miosis . . . 144
8.12.4 Hyphema . . . 144
8.12.5 Vitreous Loss and Membranes . . . 144
8.13 Typical Postoperative Complications and Their Management . . . 145
8.13.1 Inflammation . . . 145
8.13.2 Ocular Hypertension and Glaucoma . . . 145
8.13.3 Ocular Hypotony . . . 146
8.13.4 Retinal Detachment, Macular Pucker and Uveal Effusion . . . 146
8.13.5 Synechiae . . . 146
8.13.6 Hyphema and Rubeosis . . . 147
8.13.7 Posterior Capsule Opacification . . . 147
8.13.8 Deposits of cells on the IOL . . . 147
8.13.9 Contact Lenses and Amblyopia . . . . 148
8.13.10Cystoid Macular Oedema . . . 148
8.14 Visual Outcome After Cataract Surgery in Patients with Uveitis . . . . 149
8.15 Final Remarks . . . 149
References . . . 149 Contents XI
Chapter 9
Paediatric Cataract Surgery Charlotta Zetterström
9.1 Introduction . . . 153
9.1.1 Aetiology . . . 153
9.1.2 Morphology . . . 154
9.1.3 Amblyopia and Congenital Cataracts . . . 155
9.2 Congenital Dense Cataract . . . 156
9.2.1 Pre-operative Examination . . . 156
9.2.2 Surgical Technique in Infants . . . 157
9.3 Cataracts in Older Children . . . 159
9.3.1 Pre-operative Examination . . . 159
9.3.2 Surgical Technique . . . 160
9.4 IOL Power and Model . . . 160
9.4.1 Post-operative Treatment . . . 161
9.4.2 Post-operative Complications . . . 162
9.5 Current Clinical Recommendations . . . 164
References . . . 164
Chapter 10 Prevention and Treatment of Post-cataract Surgery Infection Wolfgang Behrens-Baumann 10.1 Introduction . . . 167
10.1.1 Incidence . . . 167
10.1.2 Sources of Contamination . . . 168
10.2 Prevention of Post-operative Endophthalmitis . . . 168
10.2.1 Preoperative Prophylaxis . . . 168
10.2.2 Intraoperative Prophylaxis . . . 169
10.2.3 Postoperative Prophylaxis . . . 170
10.3 Treatment of Post-cataract Endophthalmitis . . . 170
10.3.1 Diagnostic Measures . . . 170
10.3.2 Anti-infective Therapy . . . 170
10.3.3 Anti-inflammatory Therapy . . . 171
10.3.4 Surgery . . . 171
10.4 Conclusion . . . 172
References . . . 172
Refractive Surgery Chapter 11 Future Trends in Refractive Surgery Jacqueline T. Koo, Eric J. Linebarger, Richard L. Lindstrom, David R. Hardten 11.1 Introduction . . . 177
11.2 Cornea . . . 177
11.2.1 Corneal Tissue Removal . . . 177
11.2.2 Corneal Volume Addition . . . 180
11.2.3 Corneal Relaxation . . . 181
11.2.4 Corneal Compression . . . 181
11.3 Ciliary Body . . . 182
11.4 Lens . . . 182
11.5 Crystalline Lens Replacement . . . 184
11.6 Phakic Intraocular Refractive Lenses 185 11.7 Conclusion . . . 186
References . . . 186
Chapter 12 LASIK – Laser In Situ Keratomileusis Michael C. Knorz 12.1 History . . . 189
12.2 Patient Selection, Technique and Results . . . 190
12.2.1 Patient Selection . . . 190
12.2.2 Technique . . . 192
12.2.3 Results . . . 192
12.3 Complications . . . 193
12.3.1 Microkeratome-Related Flap Complications . . . 193
12.3.2 Other Flap Complications . . . 194
12.3.3 Interface Complications . . . 195
12.4 Quality of Vision . . . 196
12.5 Customized Ablations . . . 198
12.5.1 Wavefront Measurements . . . 199
12.5.2 Wavefront-Guided Treatments . . . 199
12.5.3 What Are the Benefits of Customised LASIK? . . . 199
References . . . 200 XII Contents
Chapter 13 LASEK vs PRK
Chun Chen Chen, Dimitri T. Azar
13.1 Introduction . . . 203
13.2 Surgical Technique of LASEK and PRK . . . 204
13.2.1 Personal Experience (Azar’s Technique) . . . 204
13.2.2 Camellin’s Technique . . . 206
13.2.3 Vinciguerra’s Techinique (Butterfly Technique) . . . 206
13.2.4 Gel Assisted LASEK . . . 206
13.3 Clinical Results of LASEK vs PRK . . 207
13.4 Electron Microscopy . . . 208
13.4.1 Preparation of Specimens for Electron Microscopy . . . 208
13.4.2 Electron Microscopic Analysis of Epithelial Sheets Removed Using 20% Alcohol . . . 208
13.5 Corneal Wound Healing After the Refractive Process . . . 209
13.5.1 Epithelial Wound Healing . . . 210
13.5.2 Stromal Wound Healing . . . 210
13.6 Epithelial Cell Viability . . . 210
References . . . 215
Chapter 14 Refractive Keratotomy: Does It Have a Future Role in Refractive Surgery? Mitchell P. Weikert, Douglas D. Koch 14.1 Introduction . . . 217
14.2 History of Refractive Keratotomy . . 217
14.3 Principles of Refractive Keratotomy . . . 218
14.4 Techniques of Refractive Keratotomy [5] . . . 220
14.5 Major Clinical Trials in Refractive Keratotomy . . . 223
14.6 Complications of Refractive Keratotomy . . . 225
14.6.1 Hyperopic Drift . . . 225
14.6.2 Diurnal Fluctuation . . . 225
14.6.3 Other Complications . . . 226
14.7 Refractive Keratotomy for the Management of Astigmatism . . . 227
14.7.1 Cataract Incision Placement . . . 227
14.7.2 Opposite Clear Corneal Incisions . . . 228
14.7.3 Arcuate and Transverse Keratotomy . . . 228
14.7.4 Peripheral Corneal Relaxing Incisions . . . 230
14.8 Conclusion . . . 232
References . . . 232
Chapter 15 Phakic Intraocular Lenses Dennis C. Lu, David R. Hardten, Richard L. Lindstrom 15.1 Introduction . . . 235
15.1.1 Limitations of Keratorefractive Procedures . . . 235
15.1.2 Role of Lenticular Refractive Procedures . . . 236
15.2 Evolution and Classification of Phakic IOLs . . . 236
15.2.1 Anterior Chamber Angle-Fixated Lenses . . . 236
15.2.2 Anterior Chamber Iris-Fixated Lenses . . . 240
15.2.3 Posterior Chamber Lenses . . . 241
15.3 Evaluation of the Phakic IOL Patient . . . 243
15.3.1 General Patient Factors . . . 243
15.3.2 Refraction . . . 243
15.3.3 Anatomic Factors . . . 244
15.3.4 Pre-existing Ocular Pathology . . . 244
15.3.5 IOL Sizing for Fixated Lenses . . . 244
15.3.6 IOL Calculations . . . 244
15.3.7 Peripheral Iridectomy or Iridotomy . . . 245
15.4 Surgical Technique . . . 245
15.4.1 Anterior Chamber Angle Fixated . . . 245
15.4.2 Anterior Chamber Iris Fixated . . . 246
15.4.3 Posterior Chamber Angle Fixated . . 246
15.4.4 Posterior Chamber Phakic Refractive Lens . . . 246
15.5 Post-operative Course and Enhancements . . . 246
15.6 Results . . . 247
15.6.1 Myopic Results . . . 247
15.6.2 Hyperopic Results . . . 247
15.6.3 Toric Results . . . 251
15.7 Complications . . . 251
15.8 Conclusions . . . 254
References . . . 254 Contents XIII
Chapter 16
Refractive Lens Exchange
Jose Luis Güell, Nancy Sandoval, Felicidad Manero, Oscar Gris
16.1 Introduction . . . 257
16.2 Myopia . . . 258
16.2.1 Visual Results . . . 258
16.2.2 Complications . . . 259
16.3 Hyperopia . . . 263
16.3.1 Visual Results . . . 263
16.3.2 Complications . . . 267
16.3.3 Multifocal IOLs . . . 267
16.4 Surgical Technique: Phaco-rolling . . 268
References . . . 269
Chapter 17 The Concept of Wavefront-Guided Corneal Surgery Li Wang, Douglas D. Koch 17.1 Principle of Wavefront Technology . 271 17.1.1 Basics of Wavefront Aberration . . . . 271
17.1.2 Visual Benefit of Higher-Order Aberration Correction . . . 272
17.1.3 Principles of Measuring Wavefront Aberration . . . 273
17.1.4 Quantifying Wavefront Aberrations . . . 275
17.2 Accuracy and Repeatability of Wavefront Aberrometers . . . 279
17.2.1 WaveScan . . . 279
17.2.2 Zywave . . . 280
17.2.3 COAS . . . 280
17.2.4 Tscherning Aberrometer . . . 281
17.2.5 Tracey VFA . . . 281
17.3 Clinical Outcome of Wavefront- Guided Corneal Surgery . . . 281
17.3.1 Methods . . . 281
17.3.2 Summary of Results . . . 283
17.4 Limitations of Wavefront-Guided Corneal Surgery . . . 285
17.5 Future of Wavefront-Guided Corneal Surgery . . . 285
References . . . 286
Chapter 18 The Pupil and Refractive Surgery Emanuel Rosen 18.1 Introduction . . . 289
18.2 Pupillometry and Refractive Surgery . . . 289
18.2.1 The Pupil and the Cornea . . . 290
18.3 Planning Corneal Refractive Surgery . . . 292
18.4 Pupils and Night Vision . . . 294
18.5 Pupillary Unrest, Anisocoria and Measurement . . . 295
18.6 How Should Pupils Be Measured? . . 296
18.6.1 Data Acquisition and Processing System . . . 296
18.6.2 Illumination . . . 296
18.7 Pupillometry Studies . . . 298
18.7.1 Precision . . . 298
18.7.2 Accuracy . . . 299
References . . . 302
Chapter 19 Quality of Vision After Refractive Surgery Thomas Kohnen, Jens Bühren, Thomas Kasper, Evdoxia Terzi 19.1 Introduction . . . 303
19.2 Defining Quality of Vision . . . 303
19.2.1 Subjective Symptoms . . . 304
19.2.2 Visual Function . . . 305
19.2.3 Optical Image Quality . . . 305
19.2.4 The Role of Anatomy . . . 306
19.3 Measuring Quality of Vision . . . 306
19.3.1 Subjective: Questionnaires . . . 307
19.3.2 Functional . . . 307
19.3.3 Optical: Wavefront Sensing, MTF, PS F . . . 308
19.3.4 Anatomical: Biomicroscopy, Corneal Topography . . . 310
19.4 Specific Changes in Quality of Vision After Refractive Surgery . . 310
19.4.1 Incisional Surgery . . . 310
19.4.2 Excimer Surgery . . . 311
19.4.3 Intraocular Lens Procedures . . . 312
19.5 Future Approaches to Improve Quality of Vision After Refractive Surgery . . . 312
References . . . 313
Subject Index . . . 315 XIV Contents
Arshinoff, Steve A.,MD, FRCSC York Finch Eye Associates The University of Toronto 2115 Finch Avenue W. #316
Toronto, Ontario, M3 N 2V6, Canada Azar, Dimitri T.,MD
Professor of Ophthalmology Harvard Medical School
Director of Cornea and Refractive Surgery Massachusetts Eye and Ear Infirmary 243 Charles Street
Boston, MA 02114, USA Becker, Matthias,MD Department of Ophthalmology University of Heidelberg 69121 Heidelberg, Germany
Behrens-Baumann, Wolfgang, MD Professor of Ophthalmology
Universitäts-Augenklinik Leipziger Str. 44
39120 Magdeburg, Germany Bellucci, Roberto,MD Chief of Ophthalmological Unit Hospital of Verona
Sede Legale P. le A. Stefani, 1 37126 Verona, Italy
Bühren, Jens,MD
Department of Ophthalmology Johann Wolfgang Goethe-University Theodor-Stern-Kai 7
60590 Frankfurt am Main, Germany
Chen, Chun Chen,MD
Taipei Municipal Jen-Ai Hospital 10, Sec 4, Jen-Ai Road
National Yang-Ming University, Taipei, Taiwan
Findl, Oliver,MD Professor of Ophthalmology Department of Ophthalmology Vienna University
Waehringer Guertel 18–20 1090 Vienna, Austria Fine, I. Howard, MD 1550 Oak Street, #5
Eugene, OR 97401-7701, USA Gris, Oscar,MD
Instituto Microcirugia Ocular de Barcelona c. Munner 10, 08022 Barcelona, Spain Güell, Jose Luis,MD, PhD
Associate Professor of Ophthalmology Autonoma University of Barcelona
Director of Cornea and Refractive Surgery Unit Instituto Microcirugia Ocular de Barcelona c. Munner 10, 08022 Barcelona, Spain Hardten, David R.,MD
Minnesota Eye Consultants Department of Ophthalmology University of Minnesota Minneapolis, MN 55404, USA
Contributors
Heiligenhaus, Arnd, MD Professor of Ophthalmology Department of Ophthalmology St. Franziskus Hospital Hohenzollernring 74 48145 Muenster, Germany Heinz, Carsten,MD
Department of Ophthalmology St. Franziskus Hospital Hohenzollernring 74 48145 Muenster, Germany Hoffman, Richard S., MD 1550 Oak Street, #5
Eugene, OR 97401-7701, USA Kasper, Thomas,MD
Department of Ophthalmology Johann Wolfgang Goethe-University Theodor-Stern-Kai 7
60590 Frankfurt am Main, Germany Knorz, Michael C.,Professor Dr.
FreeVis LASIK
Zentrum Universitätsklinikum Mannheim Theodor Kutzer Ufer 1–3
68167 Mannheim, Germany Koch, Douglas D.,MD
Professor and the Allen, Mosbacher, and Law Chair in Ophthalmology Baylor College of Medicine 6565 Fannin NC 205
Houston, TX 77030-2703, USA Kohnen, Thomas, MD Professor of Ophthalmology Department of Ophthalmology Johann Wolfgang Goethe-University Theodor-Stern-Kai 7
60590 Frankfurt am Main, Germany Koo, Jacqueline T.,MD
Minnesota Eye Consultants Department of Ophthalmology University of Minnesota Minneapolis, MN 55404, USA
Lindstrom, Richard L.,MD Minnesota Eye Consultants Department of Ophthalmology University of Minnesota Minneapolis, MN 55404, USA Linebarger, Eric J., MD Assistant Professor
University of California, San Diego Shiley Eye Center, 0946
La Jolla, CA 92093, USA Lu, Dennis C., MD Minnesota Eye Consultants Department of Ophthalmology University of Minnesota Minneapolis, MN 55404, USA Mamalis, Nick,MD Professor of Ophthalmology John A. Moran Eye Center University of Utah 50 North Medical Drive Salt Lake City, UT 84132, USA Manero, Felicidad,MD
Instituto Microcirugia Ocular de Barcelona c. Munner 10, 08022 Barcelona, Spain Masket, Samuel, MD
Jules Stein Eye Institute, UCLA Los Angeles, CA 90048, USA Menapace, Rupert M., MD Professor of Ophthalmology Department of Ophthalmology University of Vienna Medical School Vienna General Hospital
Waehringer Guertel 18–20 1090 Vienna, Austria Morselli, Simonetta,MD Department of Ophthalmology Hospital of Verona
Sede Legale P. le A. Stefani, 1 37126 Verona, Italy
XVI Contributors
Packer, Mark, MD 1550 Oak Street, #5
Eugene, OR 97401-7701, USA Rosen, Emanuel,MD FRCSE FRCOphth FRPS
“Rosen Eye Clinic”, Harbour City Salford, Manchester M3 4DY, UK Sandoval, Nancy,MD
Fellowship in Cornea and Refractive Surgery Autonoma University of Barcelona
Instituto de Microcirugia Ocular de Barcelona c. Munner 10, 08022 Barcelona, Spain
Terzi, Evdoxia,MD
Department of Ophthalmology Johann Wolfgang Goethe-University Theodor-Stern-Kai 7
60590 Frankfurt am Main, Germany
Wang, Li,MD, PhD Cullen Eye Institute Baylor College of Medicine 6565 Fannin, NC 205 Houston, TX 77030, USA Weikert, Mitchell P., MD, MS Baylor College of Medicine 6565 Fannin NC 205
Houston, TX 77030-2703, USA Werner, Liliana,MD, PhD Assistant Professor
John A. Moran Eye Center, University of Utah 50 North Medical Drive
Salt Lake City, UT 84132, USA Zetterström, Charlotta, MD Professor of Ophthalmology
Ophthalmology, St. Eriks Eye Hospital 11282 Stockholm, Sweden
Contributors XVII
