Current Advances in Ocular Surgery (Current Practices in Ophthalmology)

✍ Scribed by Edmund Tsui (editor), Simon S. M. Fung (editor), Rohan Bir Singh (editor)

• Publisher: Springer
• Year: 2023
• Tongue: English
• Leaves: 364
• Category: Library

✦ Synopsis

​The book discusses innovations in surgical techniques and procedures in multiple ophthalmic subspecialties with an evidence based approach.With the rapid development of the field of ophthalmology over the last 10 years, from the development of ever more sophisticated ocular diagnostic technology, to the development of novel medical therapies, ophthalmologists have seen dramatic advancements in the care of their patients.The book highlights various ophthalmic surgical techniques that have been devised, modified, and refined over the last decade, allowing ophthalmic surgeons to achieve surgical perfection. It includes illustrations, clinical photos, videos of surgical procedure. It includes easy to follow salient points in each chapter.This volume of the Current Practices in Ophthalmology book series serves as a valuable resource for post graduate residents in ophthalmology, practicing ophthalmologists, subspecialty fellows, vision science researchers, and general ophthalmologists.

✦ Table of Contents

Preface
Contents
About the Editors
Part I: Surgical Innovations for Adnexal and Oculoplastics
1: Injectables: Aesthetics and Cosmetics
1.1 Soft Tissue Filler
1.1.1 Introduction
1.1.2 Clinical Applications
1.1.3 Categories of Dermal Filler
1.1.3.1 Non-biodegradable Fillers
Poly-Methyl Methacrylate (PMMA)
Silicone
Polyalkylimide
1.1.3.2 Biodegradable Fillers
Collagen
Calcium Hydroxyapatite (CaHA)
Poly-l-Lactic Acid (PLLA)
Hyaluronic Acid Fillers (HA)
Patient Selection and Evaluation
Contraindications
1.1.4 Preparation and Post-Operative Care
1.1.4.1 Antiseptic Technique
1.1.4.2 Post-Procedural Care
1.1.5 Injection Techniques
1.1.5.1 Linear Threading (Anterograde and Retrograde)
1.1.5.2 Serial Puncture and Depot Injections
1.1.5.3 Fanning and Cross Hatching
1.1.6 Anatomical Considerations and Techniques
1.1.6.1 Forehead and Glabellar Furrows
1.1.6.2 Forehead and Temporal Fossa
1.1.7 Periorbital Region
1.1.7.1 Eyebrows
1.1.7.2 Superior Sulcus
1.1.7.3 Tear Troughs
1.1.8 Midface and Nasolabial Folds
1.1.8.1 Cheek
1.1.8.2 Nasolabial Folds Augmentation
1.1.8.3 Nose
1.1.9 Lower Face
1.1.9.1 Perioral Region
1.1.9.2 Marionette Lines and the Oral Commissure
1.1.9.3 Labiomental Fold and the Chin Apex
1.1.9.4 Jawline
1.1.10 Soft Tissue Filler Complications
1.1.10.1 Technique for Reversal
1.1.10.2 Ecchymosis
1.1.10.3 Infection and Biofilm Production
1.1.10.4 Granulomas
1.1.10.5 Improper Filler Placement or Migrated Filler
1.1.10.6 Skin Necrosis
1.1.10.7 Ophthalmic Complications
1.2 Botulinum Toxins
1.2.1 Introduction
1.2.2 Clinical Applications
1.2.3 Mechanism of Action
1.2.4 Patient Selection and Evaluation
1.2.5 Contraindications
1.2.6 Preparation and Post-Operative Care
1.2.6.1 Preparation and Storage
1.2.6.2 Post-Procedural Care
1.2.7 Injection Techniques
1.2.8 Anatomical Considerations and Techniques
1.2.8.1 Frontalis
1.2.8.2 Glabella
1.2.8.3 Orbicularis Oculi
1.2.8.4 Pharmacologic Brow Contouring
1.2.8.5 Nasal Rhytids
1.2.8.6 Perioral Region
1.2.8.7 Masseter
1.2.8.8 Mentalis
1.2.8.9 Platysma
1.2.9 Botulinum Toxins Complications
1.2.10 Injection Site Reactions
1.2.11 Under-Correction
1.2.12 Ptosis
1.2.13 Brow Ptosis
1.2.14 Brow Asymmetry
1.2.15 Diplopia, Lagophthalmos, and Dry Eyes
1.2.16 Lip Ptosis
1.2.17 Dysphagia
1.2.18 Systemic Complications
1.2.19 Future Directions
References
2: Fornix Reconstruction
2.1 Mucous Membrane Substitution
2.1.1 Contralateral Conjunctiva
2.1.2 Buccal or Labial Mucous Membrane
2.1.3 Nasal Mucosa Graft
2.1.4 Hard Palate Graft
2.1.5 Dermis Fat Graft
2.1.6 Temporoparietal Fascial Flap
2.1.7 Tarsoconjunctival Flap
2.1.8 Amniotic Membrane Graft
2.2 Forniceal Deepening
2.3 Maintaining Separation of Healing Surfaces
2.4 Summary
References
Part II: Surgical Innovations for Cataract
3: Capsulotomy and Lens Fragmentation
3.1 Anterior Capsulotomy: Manual Curvilinear Capsulorhexis, Femtosecond Laser Capsulotomy, and Precision Pulse Capsulotomy
3.1.1 Historical Perspective
3.1.2 Adequacy of Capsulotomy for Successful Cataract Surgery
3.1.3 Introduction to Femtosecond Laser Capsulotomy (FSLC)
3.1.4 Applications of Femtosecond Laser Capsulotomy (FLSC)
3.1.5 Introduction to Precision Pulse Capsulotomy (Zepto)
3.1.6 Applications of Precision Pulse Capsulotomy
3.2 Lens Fragmentation: Femtosecond Laser-Assisted and Micro-Interventional Lens Fragmentation
3.2.1 Historical Perspective
3.2.2 Introduction to Femtosecond Laser (FSL) for Cataract Lens Fragmentation
3.2.3 Applications for Femtosecond Laser Lens Fragmentation
3.2.4 Introduction to Micro-Interventional Lens Fragmentation
3.2.5 Applications of the miLOOP
3.2.6 Conclusion and Future Directions
References
4: Scleral-Fixated Intraocular Lenses
4.1 Introduction
4.2 Background
4.3 Indications and Risk Factors
4.3.1 Subluxation/Dislocation of the Lens
4.3.2 Inadequate Capsular Support
4.4 Glued Intrascleral Haptic Fixation of an IOL (Glued IOL)
4.4.1 Lens and Suture Selection
4.4.2 Surgical Technique
4.4.3 Modifications to the Surgical Technique
4.4.4 Outcomes
4.5 Flanged Intrascleral IOL Fixation with Double-Needle Technique (Yamane Technique)
4.5.1 Lens and Suture Selection
4.5.2 Surgical Technique
4.5.3 Outcomes
4.6 Canabrava Four-Flanged Scleral Fixation Technique
4.6.1 Lens and Suture Selection
4.6.2 Four-Flanged Scleral Fixation of a Two-Eyelet Non-Foldable IOL
4.6.3 Four-Flanged Scleral Fixation of a Four-Eyelet Foldable IOL
4.6.4 Outcomes
4.7 McCabe Belt Loop Technique for Scleral Fixation
4.7.1 Lens and Suture Selection
4.7.2 Surgical Technique
4.7.3 Outcomes
4.8 Complications
4.8.1 Complications in Glued SFIOL
4.8.2 Complications in Flanged, Double-Needle SFIOL
4.8.3 Complications in Canabrava and McCabe Belt Loop SFIOL
4.9 Comparisons between Scleral Fixation Techniques
4.10 Conclusion
References
5: Iris Implants
5.1 Indications for Artificial Iris Device Implantation
5.2 Types and Manufacturers of Iris Prostheses
5.2.1 Morcher
5.2.2 Ophtec
5.2.3 HumanOptics
5.2.4 Reper-NN
5.3 Selecting an Appropriate Device
5.4 Surgical Technique
5.5 Complications of Artificial Iris Implantation
5.6 Device Availability
5.7 Future Directions
References
6: New Lenses
6.1 Introduction
6.2 Terminology
6.3 New Classification
6.3.1 Small-Aperture IOLs
6.3.1.1 The IC8-IOL (Acufocus Inc.)
6.3.2 Wavefront-Correcting IOLs
6.3.2.1 The Mini Well IOL (Sifi Medtech)
6.3.2.2 The Vivity IOL DFT015 (Alcon)
6.4 Full Range of Focus Lenses
6.4.1 RAYNER Sulcoflex Trifocal®
References
Part III: Surgical Innovations for Refractive Procedures
7: Laser Surface Ablation Procedures
7.1 Introduction
7.2 Surface Ablation
7.2.1 Photorefractive Keratectomy
7.2.2 Transepithelial PRK
7.2.3 Phototherapeutic Keratectomy
7.2.4 Conclusion
References
8: Small Incision Lenticule Extraction
8.1 Indications of SMILE Surgery
8.2 Preoperative Preparations
8.2.1 Patient Preparations
8.2.2 Instrument Preparation
8.3 Surgical Design and Procedure
8.3.1 Surgical Design
8.3.1.1 Corneal Cap
8.3.1.2 Lenticule
8.3.1.3 Incision
8.3.1.4 Energy Setting
8.3.1.5 Nomogram Adjustment
8.4 Surgical Procedures
8.4.1 Anesthesia
8.4.2 Docking
8.4.3 Centration
8.4.4 Lenticule Creation
8.4.5 Lenticule Separation and Extraction
8.4.6 Surgical Sequence Selection
8.4.7 Incision Management
8.4.8 Postoperative Management
8.5 Complications and Managements
8.5.1 Intraoperative Complications
8.5.1.1 Suction Loss
8.5.1.2 Opaque Bubble Layer (OBL)
8.5.1.3 Appearance of “Black Areas” in the Scanned Area
8.5.1.4 Difficulties in Identifying the Stromal Lenticule
8.5.1.5 Difficulties in Lenticule Separation
8.5.1.6 Tears at the Incision or Cap
8.5.1.7 Lenticular Tear or Remnant
8.5.1.8 Decentered Lenticule
8.5.1.9 Foreign Body Beneath the Cap (Interface Debris)
8.5.1.10 Bleeding
8.5.2 Postoperative Complications
8.5.2.1 Diffuse Lamellar Keratitis (DLK)
8.5.2.2 Corneal Stromal Haze
8.5.2.3 Corneal Striae or Folds
8.5.2.4 Epithelial Island or Epithelial Ingrowth
8.5.2.5 Infection
8.5.2.6 Corneal Sterile Infiltrates
8.5.2.7 Dry Eye
8.5.2.8 Symptoms of Poor Vision: Cloudy Vision, Glare, and Halo
8.5.2.9 Regression or Under-Correction
8.6 Refractive Outcomes of SMILE
8.6.1 Long-Term Outcomes
8.6.2 Outcomes of High Myopia
8.6.3 Outcomes of Myopic Astigmatism
8.6.4 Outcomes of Higher-Order Aberrations
8.7 Advantages of SMILE
8.7.1 Stability of Corneal Biomechanics
8.7.2 Less Corneal Damage and Faster Corneal Nerve Recovery
8.7.3 Wound Healing
8.8 Lenticule Tissue Applications
8.9 Future Directions
References
9: Phakic Intraocular and Implantable Collamer Lenses
9.1 Introduction
9.2 Types of PIOL
9.3 Indications and Contraindications
9.4 Preoperative Evaluation
9.5 Sizing of the ICL
9.6 Surgical Technique
9.7 Outcomes
9.8 Complications
9.8.1 Endothelial Cell Loss
9.8.2 Glaucoma
9.8.3 Cataract
9.9 Future Directions
References
10: Corneal Cross-Linking
10.1 Background
10.2 Indications
10.3 Contraindications
10.4 Procedure
10.5 Postoperative Care
10.6 Complications
10.7 Variations of Standard Technique
10.7.1 Modifications to Riboflavin Delivery
10.7.2 Modifications to UV Exposure
10.7.3 Modifications to Oxygen Availability
10.8 Treatment Outcomes
10.9 CXL-Plus (“Refractive-Plus”)
10.9.1 Conductive Keratoplasty
10.9.2 Surface Ablation
10.9.3 Phakic IOLs
10.9.4 LASIKxtra
10.10 Future Directions/Novel Uses
References
Part IV: Surgical Innovations for Cornea and External Diseases
11: Simple Limbal Epithelial Transplantation
11.1 Introduction and History
11.2 Indications
11.3 Contraindications and Poor Prognostic Factors
11.4 Surgical Technique
11.5 Postoperative Care and Follow-Up
11.6 Advantages
11.7 Complications
11.8 Modifications and Recent Advances
11.9 Outcomes
11.10 Concluding Remarks and Future Directions
References
12: Updates on Therapy for Cornea Edema
References
13: Corneal Neurotization
13.1 Introduction
13.2 Neurotrophic Keratopathy
13.2.1 Anatomy and Pathophysiology
13.2.2 Diagnosis and Clinical Presentation
13.2.3 Management
13.3 Development and Physiology of Corneal Neurotization
13.3.1 History
13.3.2 Corneal Nerve Regeneration and Functionality
13.4 Modern Corneal Neurotization Techniques
13.4.1 Anatomy of Donor Nerves and Coaptation
13.4.2 Direct Approaches (Table 13.1)
13.4.3 Nerve Graft-Based (“Indirect”) Approaches (Table 13.2)
13.4.4 Comparative Analysis and Outcomes
13.5 Current Limitations and Controversies
13.6 Future Directions
References
14: Keratoprosthesis
14.1 Introduction
14.2 Design
14.3 Indications
14.3.1 Inclusion and Exclusion Criteria
14.3.2 Implications of the Underlying Indication on Outcomes
14.3.3 Specific Indications and Considerations for Keratoprosthesis Implantation
14.3.3.1 Prior Graft Failure
14.3.3.2 Limbal Stem Cell Deficiency
14.3.3.3 Primary Keratoprosthesis Implantation
Chronic Hypotony and Pre-Phthisis
14.3.3.4 Pediatric Keratoprosthesis Implantation
14.3.3.5 Bilateral Keratoprosthesis Implantation
14.4 Preoperative Evaluation
14.4.1 Eyelid and Blink Function Assessment
14.4.2 Ocular Surface and Anterior Segment Examination
14.4.3 Evaluation of Glaucoma Status
14.4.4 Posterior Segment Evaluation and Assessment of Potential for Vision
14.5 Surgical Technique and Intraoperative Considerations
14.6 Postoperative Management
14.6.1 Antimicrobial Prophylaxis
14.6.2 Bandage Contact Lens
14.6.3 Glaucoma Management
14.6.3.1 Other Considerations
14.7 Outcomes
14.7.1 Visual Outcomes
14.7.2 Retention Outcomes
14.8 Complications
14.8.1 Retroprosthetic Membrane
14.8.2 Glaucoma
14.8.3 Sterile Corneal Necrosis
14.8.4 Infectious Keratitis
14.8.5 Endophthalmitis
14.8.6 Idiopathic Vitritis
14.8.7 Other Posterior Segment Complications
14.8.7.1 Hypotony
14.9 Future Directions
References
Part V: Surgical Innovations for Glaucoma
15: Microinvasive Glaucoma Surgery
15.1 Introduction
15.2 Schlemm’s Canal Devices/Procedures
15.2.1 Trabectome
15.2.2 iStent and iStent Inject
15.2.3 Kahook Dual Blade
15.2.4 Hydrus Microstent
15.3 Ab Interno Trabeculotomy Procedures and Devices
15.3.1 Gonioscopy-Assisted Transluminal Trabeculotomy
15.3.2 Omni
15.4 Suprachoroidal Devices
15.4.1 Cypass
15.4.2 iStent Supra
15.5 Subconjunctival Devices
15.5.1 XEN® Gel Stent
15.5.2 PRESERFLO (InnFocus) MicroShunt
15.6 Cycloablation Procedures
15.6.1 Endoscopic Cyclophotocoagulation
15.7 Economic and Quality of Life Considerations
15.8 Ethical Considerations
15.9 Quality of Evidence
15.10 Conclusion
References
16: Ahmed ClearPath, PAUL Glaucoma Implant, and Aurolab Aqueous Drainage Implant
16.1 Glaucoma Drainage Devices
16.1.1 Preoperative Considerations
16.1.2 Surgical Technique and Pearls
16.1.3 Postoperative Management and Monitoring
16.2 Ahmed Clearpath Glaucoma Drainage Device
16.2.1 Introduction
16.2.2 Features of the Device
16.2.3 Advantages and Disadvantages
16.2.4 Clinical Studies
16.3 AUROLAB Aqueous Drainage Implant
16.3.1 Introduction
16.3.2 Features of the Device
16.3.3 Advantages and Disadvantages
16.3.3.1 Clinical Studies
16.4 PAUL Glaucoma Drainage Implant
16.4.1 Features of the Device
16.4.2 Advantages and Disadvantages
16.5 Clinical Studies
16.6 Special Populations and Considerations
16.7 Future Directions
References
Part VI: Surgical Innovations for Retina
17: Advances in Vitrectomy
17.1 Introduction
17.2 Advances in Gauge Size
17.3 Advances in Duty Cycle
17.4 Other Advances in Vitreous Cutters
17.5 Advances in Fluidics
17.6 Advances in Forceps and Adjunct Tools
17.7 Advances in Lighting
17.8 Conclusion
References
18: Advancements in Visualization
18.1 Introduction
18.2 Addressing the Media
18.3 Wide-Angle Viewing Systems
18.4 Macula Flat Lenses
18.5 Chromovitrectomy
18.6 Endoillumination
18.7 Three-Dimensional Heads-Up Visualization
18.8 Endoscopic Vitrectomy
18.9 Intraoperative Optical Coherence Tomography
18.10 Conclusion
18.11 Future Directions
References
19: New Avenues of Delivery (Subretinal Gene Therapy, Port Delivery, Suprachoroidal)
19.1 Introduction
19.2 Subretinal Delivery
19.2.1 Surgical Maneuvers
19.2.2 Gene Therapy
19.2.3 Stem Cell Transplantation
19.2.4 Retinal Implants
19.3 Surgically Implanted Extended-Release Therapeutic
19.3.1 Introduction
19.3.2 The Surgical Implantation of the Port Delivery Device
19.3.3 The Usage and Refill of the Port Delivery Device
19.3.3.1 Ranibizumab PDS System
19.3.4 The Results of the Port Delivery System
19.3.5 Discussion of the Port Delivery System
19.4 Suprachoroidal Delivery
19.5 Conclusion
References
Part VII: Surgical Innovations for Strabismus
20: Vessel-Sparing Strabismus Surgeries
20.1 Introduction
20.2 Partial Tenotomy
20.2.1 Surgical Technique
20.3 Plication
20.3.1 Surgical Technique
20.4 Vessel-Sparing Transposition Techniques
20.4.1 Surgical Technique
20.4.1.1 Nishida Procedure
20.4.1.2 Superior Rectus Transposition (SRT)
20.4.1.3 Inferior Rectus Transposition (IRT)
20.4.1.4 Vertical Rectus Transposition (VRT) with Adjustable Technique
20.5 Future Directions
References