Surgical Management of Astigmatism Jorge L Alio, Dimitri T Azar, M Soledad Cortina, Joelle A Hallak
INDEX
Page numbers followed by b refer to box, f refer to figure, and t refer to table
A
Aberrations 132, 170
asymmetric 269
coma-like 269
corneal 271
lower-order 60
spherical defocus, lower order 276
Aberrometric parameters 165
Aberrometry 60, 62, 64, 110, 121, 165
advantages of 133
based systems 134
technology 60
total 60
Abulafia-Koch calculators 95
Accommodation 13, 20
AcrySof astigmatic correction 102t
AcrySof toric 101, 106
characteristics 101f
dimensions 101f
intraocular lens 102, 102t, 159f
Adjunctive refractive surgical procedures 267
Air bubbles 134
Allergic reactions 145
Alpins method 88f, 225t
Alpins vector analysis 112
Ametropia 296
Amsler-Krumeich classification 165
Anesthesia 301
Angle closure glaucoma 286
Aniseikonia 305
Anterior biomicroscopy examination 68f, 72f
Anterior chamber 288, 296
depth 165
Anterior corneal parameters 24f
Anterior corneal surface 40, 46f, 91, 150
area 56, 57
Anterior minimum thickness point deviation 57
Anterior segment optical coherence tomography 48, 92, 299f
Apex deviation
anterior 57
posterior 57
Aphakia type 296
Arcuate incisions 177, 242, 244f
Arcuate keratotomy 69, 146, 181, 182, 184, 250, 272
planning of 183
Artiflex® implantation forceps 301f
Artiflex® toric phakic intraocular lens 302f
Artisan phakic intraocular lens implantation 301f
Aspheric surface 29f
Asthenopia, causes of 137
Astigmatic axis, misalignment of 141
Astigmatic cornea 274
ablations of 189
normal 165
surgery 178
Astigmatic correction 218
historical methods of 197
Astigmatic dial 19
Astigmatic incisions 175
placement of 176
Astigmatic keratotomy 22, 87, 124, 157, 173, 180, 242, 249, 253
advantages of 174
incisions 124
procedures 87
Astigmatism 3, 7, 18, 22, 34, 60, 62, 64, 66, 81, 83, 91, 103, 117, 136, 137, 144, 146, 149, 151, 154, 174, 186, 221, 242f, 186, 250, 258, 283
after cataract surgery 136, 137
management of 249
amount of 148, 150, 156, 174
analysis of 22
assessment 117, 144
asymmetric 188
axial 225t
classification of 232f
compound
hyperopic 18f, 203, 204f, 224
myopic 20f, 202, 203, 224
congenital 148
contact lenses correction of 21, 146
corneal topographic 23, 24
correct 150, 251
congenital 181
residual 159, 253
correction 85, 111, 112, 121, 124, 125, 131, 136, 140, 216f, 221, 222, 283
detecting 142
different types of 222, 224, 227
effects of 136
epidemiology of 1
etiology of 1, 3
exception of 271
forms of 250
high 137
degrees of 243t
levels of 139
incisional management of 122
internal 33, 58
irregular 36, 66, 69f, 71, 71f, 72f, 74, 82, 144, 145, 148, 155, 170, 176, 204, 231, 238f, 296
keratometric 92
laser-assisted in situ keratomileusis for 186
lenticular 91, 160f
less irregular 174
low 88
lower limit 238
low-to-moderate 183t
magnitude of 8
managing residual 154
mean correction of 199
measurement of irregular 271
might reduce 124
mixed 19f, 186, 189, 202, 203, 221, 223, 224, 225t, 226, 228
nature of 117
ocular residual 22, 22f, 885, 86f
operative management of 117
optical clinical assessment of 22
optics of regular 12
original description of 5f, 6f
outcomes, analysis of 85
pathogenesis of 1, 3
permanent central 139
post-cataract 142, 145, 152
residual 137
posterior 93, 94
postoperative 136, 137, 139
predicting surgically-induced 156
preexisting 148
preoperative 103, 108
evaluation of 79
prevalence of 1, 137
post-cataract induced 137
prevention of 136, 137
pseudophakic 250, 254
refractive 253
rates 2
refractive 136
regular 17, 36, 66, 106, 145, 155, 156, 186, 231, 234f
corneal 36
residual postoperative 305
residual refractive 257
results 173
risk factors of 3
simple 188
hyperopic 21, 188, 198, 201
spectacle correction of 19, 21
strategy for debulking 174
successful treatment of 195
surgery, optical clinical assessment of 22
surgical treatment of 53, 60
surgically induced 88, 99, 118, 122, 139, 142, 154, 155, 168, 182, 222, 249
symmetric oblique 63f
tangential 225t
target-induced 88f, 120, 222
temporary central 139
topographic 39f
topography-guided surgical correction of 271
treatment 143
corneal based 79, 81
lens based 79, 81, 82
types of 223, 223t
uncorrected 20, 137
vector
analysis of 87, 103
surgically-induced 225
target-induced 87, 225
Asymmetric bow tie 231, 232f, 238f
Athens protocol 279b
Augmenting horizontal compression sutures 244f
Autoimmune disease 148
Autokeratometer 23
Automated lamellar keratoplasty, development of 196
Axial curvature
anterior 44f
map 30f, 32f
B
Baltimore eye study 2
Baylor toric intraocular lens 81
nomogram 81t
Belin-Ambrósio-enhanced ectasia 42f
display deviation 41
Best corrected visual acuity 205, 206, 241, 269
Best-fit aspheric and best-fit topic aspheric surfaces 43
Bifocal toric intraocular lens 105, 110
Biometry 80
Bioptics approach 256
Bipolar cautery 130
Bitoric laser in situ keratomileusis 192
Blended vision 257
Blue mountains eye study 2
Blunt spatula 151
Bowman's layer 137, 139
Bowman's membrane 181, 234
Bunsen-Roscoe law 266
C
Callisto eye system 119, 131f
Cambridge Philosophical Society 4
Cap tear 217
Capsular bag decentration 256
Capsular tension rings 257
Capsule opacification, posterior 257
Cassini's display 50f
Cataract 164, 171, 289, 303, 307
correction 69
extraction 182
techniques 138
frequency of 139
lens, intraocular 86, 87, 91, 92
nuclear sclerotic 93
posterior subcapsular 170f
surgeons 136
majority of 130
surgery 7, 53, 79, 85, 89, 125, 137, 139, 143, 146, 148, 162, 164, 165, 166f, 171, 182, 192, 250, 253, 254, 287
evaluation 72f
microincisional 168, 249
preoperative planning for 91
primary 255
procedures 7
refractive results of 178
residual astigmatism after 136, 138, 259
routine 175
undergoing 175
Catastrophic complication 304
Central cornea 147, 189
curvature 138
thickness 197
Central scar, flattening of 275
Central topographic ectasias 267
Chronic epithelial defects 148
Ciliary sulcus 255f, 290
Clear vision interval 252
Coaxially sighted corneal light reflex 272
Collagen
cross-linking 205
shrinkage 148
vascular diseases 141
Compression sutures 243
Computed anatomy corneal modeling system 27
Conjunctiva 143
Conjunctival vasoconstriction 118
Conjunctivitis, toxic 145
Conoid of Sturm 15, 17, 17f-20f, 67
Contact biometers 80
Contact lenses 80, 143, 145, 145f, 146, 231, 240, 241, 264, 279
intolerance, steep keratoconus with 167f
soft 143
spherical soft 21
wear 137
Contrast sensitivity 110-112
loss of 251
Convex surface, radius of 26f
Cornea 53, 119, 144, 146, 149, 164, 266
aberrated 66
analysis of 55f
anterior curvature of 32
anterior surface of 25
asphericity of 275
axial curvature map of 30f
before surgery 214f
dioptric power of 53
distorted 34
human 91
irregular 279
mid-peripheral 147
morphogeometric analysis of 53
normal 173f
optical power of 32
peripheral 147, 249
posterior 95
post-laser-assisted in situ keratomileusis 273f
problematic 273
steepening of 279
thin 188
virtual 3D modeling of 54
Corneal aberrometric analysis, right eye 106f
Corneal aberrometry 44, 60
Corneal abrasions 145
Corneal anterior surface 29f
Corneal approaches 231, 233
Corneal asphericity 187
Corneal astigmatism 4, 22f, 23, 36, 53, 58, 91, 137, 138, 192, 256, 296
anterior 23
correct regular anterior 155
correction of 137, 178, 182, 184, 184f
determination of 33
high 182
irregular 66, 145f, 155, 241f
measuring posterior 80
preexisting 113, 139, 249
preoperative 253
range of 180
regular 66, 145f
surgical correction of 184
techniques for measuring posterior 92
treatment of 253
Corneal biomechanics 37
Corneal collagen 148, 279
cross-linking 262, 265, 279
Corneal curvature 28, 92, 144, 298
anterior 24, 214f
posterior 24
Corneal decomposition, late 303
Corneal ectasia 48, 148
progressive 265
Corneal ectatic disorders 262, 265
surgical management of 262
treatment of 262
Corneal edema 134, 303, 304
moderate 304f
Corneal endothelium 266, 306
Corneal examination 143
Corneal flattening 262
Corneal haze 267, 280
Corneal higher order aberration 265
Corneal incisions 124, 139, 139f
astigmatic effect of 89f
effect 138f
large 168
nomogram 238t
opposite clear 231
Corneal infections 148
Corneal injury 272
Corneal interactive programmed topographic ablation 205
Corneal irregularity 69, 274
development of 272
measurement 67
Corneal laser ablation 142
Corneal measurements, posterior 158f
Corneal morphology abnormalities 4
Corneal neovascularization 137
Corneal pachymetric map 264
Corneal pachymetry 263
Corneal plane 86
Corneal power 32, 93
Corneal procedures 85
Corneal regularity 167f
Corneal relaxing incisions 180
Corneal scarring 137, 272
Corneal sensation 176
Corneal stability 140
Corneal stroma 262, 266, 268
superficial 187
Corneal surface
area, total 57
posterior 40, 46f, 56, 57, 91, 275
Corneal surgery 85, 90, 148
future 155
Corneal surgical correction 161
Corneal suture
effect 138f
removal of 146
Corneal tears 176
Corneal thinning 137
Corneal tissue 262, 272
Corneal tomography 36, 48, 54, 80, 144
advanced 36
Corneal topography 25, 33, 36, 60, 63f, 80, 144, 165, 293f
Corneal transplantation 83, 171, 271
Corneal treatment, topography-guided 271
Corneal videokeratography 242f
Corneal volume, total 56, 57
Corneal warpage, owing to 156
Corneal wavefront 276
analysis 43
topography-guided treatment, retreatment with 273f
treatments 233
Corneal wedge, manual resection of 244
Corneoscleral incision 301
Correct corneal astigmatism 812
after keratoplasty 182
Correction index 222, 225
Corticosteroids 145
Cross-cylinder
ablation 191
technique 188
Crystalline lens 299
Curvature
diopters of 31, 34
maps 28, 31
rays of 31
shorter radii of 33
Custom ablation 144, 205, 206
Cycloplegic refraction 24
Cyclotorsion 128, 156
alignment 274
amount of 118
Cylindrical lens focuses light 16f
Cystoid macular edema 142
D
Decentration 217
Deep anterior lamellar keratoplasties 240
Descemet's membrane 176
endothelial keratoplasty 155
Descemet's stripping automated endothelial keratoplasty 48, 155
Diabetes vascular diseases 141
Diffuse lamellar keratitis 218
Dioptric corrections, low 217
Diplopia 273
Distance vision 113
Distortions, mid-peripheral 147
Donnenfeld nomogram 174, 175f, 182, 233, 253
Donor cornea 171
Double-angle vector diagram 87
Down syndrome 4
Dry eyes 80, 176
syndrome 68f, 143, 218
Dysphotopsias 254
E
Ectasia 218
risk of 187
Ectatic disorders 148
Edema, transient 267
Elevation maps 40
Emmetorpia 12, 249, 250, 252
Enantiomorphism 28
Endophthalmitis 290, 303
infectious 304
Endothelial cell 150, 181, 289, 299
count 165, 254
density 292, 292f
loss 289, 299
percentage of 292
Endothelial damage 303
Endothelial decompensation 307
Endothelium 266, 299
Energy microwave pulse 267
Epithelial abrasions 217
Epithelial basement membrane dystrophies 80
Epithelial corneal haze 274
Epithelial irregularity 134
Epithelium 218, 238f
Error
angle of 222, 225
magnitude of 222, 225
European Eye Epidemiology Consortium 2
European Society of Cataract and Refractive Surgeons 256
Excimer laser 149, 231, 233, 249
ablation 149, 157, 250
astigmatic correction 221
procedures 149
surgery 22, 85, 88
Eye 250, 252
aberrations of 60, 62
contralateral 121, 128
emmetropic 13f
excimer laser in 251t
hyperopic 13f, 305
non-keratoconic 168
operative 176
percentages of 169f
phakoemulsification incision in 183t
post-refractive surgery 139
right 233f
segment, anterior 287f
strain 137
topography of
left 69f, 71f, 73f, 74f
right 69f, 73f, 74f
tracking component 131
vision in 279
Eyelid tumor 4
Eyewear, use of corrective 157
F
Far point 13
Faster visual recovery 297
Femtosecond arcuate keratotomy 180
indications 180
principles 180
techniques 180
Femtosecond-assisted wedge resection 244f
Femtosecond astigmatic
incision, placement of 178f
keratotomy 181, 182
Femtosecond incisions 235f
Femtosecond intrastromal incisions, laser nomogram for 177t
Femtosecond laser 177, 214f, 231, 235
arcuate keratotomy 243t
assisted
arcuate incisions 178
astigmatic keratotomy 259
cataract surgery 177
corneal incisions 178
in situ keratomileusis 222, 223t, 224, 250, 251f
incisions 178
intrastromal arcuate keratotomy 253
keratotomy, advantage of 181
cataract surgery 123
nomogram 183t
technology 130
Femtosecond spots, spiraling-in application of 214f
Floppy iris syndrome, intraoperative 123f
Forme fruste keratoconus 188
Fourier analysis 34, 234f, 237f
Freehand marking technique 129f
G
Galilei Placido-dual Scheimpflug analyzer 91, 92
Geometric optics 66
Giant cell deposits 306f
Glare intensity 111
Glare phenomena 180
Glaucoma 307
H
Half-depth central corneal 301
Hansatome microkeratome 208
Haptic configuration 134
Heijde's formula 298
Higher-order aberration 60, 73f, 144, 187, 207, 224, 257, 267
Higher-order ablation profile 233f, 234, 234f
Holladay report equivalent keratometric reading detail display 41
Holos IntraOp aberrometry system 133f
Hydrophobic acrylic 114
Hyperopia 12, 13, 13f, 61, 161, 250, 283
cylindrical 189
degree of 279
moderate 148
spherical 189
Hyperopic astigmatism 202, 221, 223, 224, 225t, 226, 228
correction of 224
Hyperopic cylindrical laser ablation 190f
Hyperopic error 276
Hyperopic spherical ablations 188
Hyperopic with-the-rule astigmatism 190f
Hyperplasia, epithelial 191
Hypertension, ocular 289
Hyphema 303
I
Image-guided techniques 118, 130
Implantable collamer lens 283, 284, 286, 288f
advantages of 284
disadvantages of 284
insertion 288f
surgery 287, 287f, 289f
Implantation nomograms 263, 264
Incision, analysis of 89
Incisional keratorefractive surgery 146, 147f, 148
Incisional keratotomy 122, 125
Infection 218
Inferior paracentral cone 45f
Interface fluid collection 218
Interlenticular opacification 254
Intracorneal ring segment 262, 263, 263f
implantation 262
Intraocular aphakic intraocular lens implant location 37
Intraocular approaches 231
Intraocular lens 81, 102, 141, 143, 144, 155, 251, 284
alignment 131
calculation 165
decentered 303
exchange 249, 256, 258
explantation 256f
implantation 112, 143, 249
light-adjustable 257
luxation 303
master 119f
original 150
placement of 136, 144
plane 102t
replacement 161
repositioning 257
rotation
postoperative 111
time frame for 159
spherical power 133
types of 250
Intraocular pressure 289, 291, 292f, 302
elevation 254
Intraocular procedures 150
Intraocular surgery 150, 287
Intraoperative aberrometry 125, 128, 132, 133, 134, 157f
Intraoperative alignment techniques 128
Intraoperative tracking system 131f
Intrastromal arcuate
incisions 233t
keratotomy 181f, 182f
Intrastromal corneal haze 274
Intrastromal incisions
non-penetrating 253
small 130
Intrastromal lenticule 150, 214f
Iridectomy, large peripheral 304f
Iris
bridge 302
clip toric phakic intraocular lens 296, 299
calculation 300
implantation 307
complications of 303b
malpositioned 303f
damage 303
fingerprinting 130
posterior pigmented epithelium of 254
prolapse 303
registration 274
Irregular astigmatism
correct 145
custom treatment of 231
excimer laser corrections of 234
index 67
Irregularity index 38
J
Jackson's cross cylinder 19
Javal keratometer 32
K
Keratectomy 96
laser-assisted subepithelial 233
photorefractive 69, 149, 187, 196, 205, 221, 222, 223, 233, 272
phototherapeutic 198
Keratitis 274
punctate 145
Keratoconic
corneas 165, 205
eye 39f, 164, 171
Keratoconus 34, 36, 41f, 69f, 96, 143, 148, 155, 164, 168, 171, 174, 188, 205, 262, 266, 267, 272, 296
advanced 170
diagnosis of 268
eyes 168
history of 70f
pediatric 269
probability index 43
severe 70f
stable 96f
treatment of 262
wear 264
Keratometer 144
manual 23
Keratometric astigmatism
preoperative 112
total 91
Keratometric devices 25
Keratometric index 33, 92
Keratometric map 39f
Keratometric power 32f
Keratometric readings 267
Keratometry 25
automated 32
history of 25
measurements 165
optical 156
posterior 48
procedures 156
Keratopathy, superficial punctate 274
Keratoplasty 69, 70, 155, 262
conductive 148, 148f
penetrating 7, 43t, 48, 71, 171, 240, 262
photorefractive 244
postpenetrating 96
Keratorefractive surgery 60, 143, 144, 146
Keratoscopic devices 25
Keratotomy
intrastromal astigmatic 180
partial penetrating 146
single arcuate 183t
trapezoidal 146
Keystone procedure 173
Kruskal-Wallis test 56
K-values 165
L
Lamellar refractive surgery 195
Laser
ablation treatment, topography-guided 281
correction, keratorefractive 250
keratorefractive surgery 256
nomogram 177t
peripheral iridotomy 305
photoablative refractive surgery 69f
refractive surgery 186, 187, 249, 259, 271
astigmatic correction 222, 223t
suction ring 142
Laser-assisted in situ keratomileusis 60, 69, 86, 95, 143, 150, 186, 189f, 195, 204f, 209, 213, 215, 221, 223, 224, 228, 233, 235, 235f, 244, 250, 258, 272
ablation 189, 192
clinical results of 224
evaluation 68f, 69f
flap 235f
complications 149
thickness 188
hinge placement 208
procedure 192, 278
refinement 252
surgery 71f, 72, 73
wavefront optimized 223
Laser-assisted wedge width calculation 244f
Lens 186, 266
based procedures 259
disadvantages of 254
natural 299, 302
posterior chamber 296
selection, calculation of 286
setting 288
spherical 16f
thin 21
vaulting 307
Lenstar biometer platform 131
Lenticular fragments 217
Lenticule
difficult dissection of 217
refractive posterior surface of 214f
tears 217
Lentis tplus 101
Lidocaine gel 176
Light waves, distortions of 132
Light-emitting diode 38
Limbal relaxing incision 22, 87, 124, 146, 147, 173-175, 175f, 231, 253
Donnenfeld nomogram for 233
surgery 87, 90
Limbal stem cell 266
deficiency 145
Limbal vessels 119
Limbus 119
Lindstrom nomogram 182
modified 182t
Lumera microscope 119
M
Macular burn 303
risk of 304
Macular edema 254, 256
incidence of 113
Meibomian gland 68
function 68
occlusion 68f
Membrane dystrophy 149
Meridional aniseikonia 145
Miotic eye 257
Modulation transfer function 62, 64
Monofocal toric intraocular lens 101, 105
implantation 101, 112
models 101t
Morphogeometric analysis 55
Multifocal intraocular lens 107t, 108, 114, 252
presbyopia-correcting 249
Multifocal piggyback intraocular lens 256
Multifocal toric intraocular lens 105, 109, 112, 114
implantation 107, 112
Multiple image-guidance systems, development of 130
Multiple keraflex applicators 267
Mydriasis 254
Myopia 12, 13, 13f, 61, 150, 161
cylindrical 189
minimizing 256
moderate 294
nuclear 285
spherical 189
treatment of 283
Myopic astigmatic treatments, simple 200
Myopic astigmatism 150, 186, 199t, 213, 221-224, 225t, 227
accommodate ablation for 235f
simple 20f, 21, 198, 200
treatment of compound 203f
Myopic cylinder 189
treatment 188
Myopic error, spherical 276
Myopic eye 301
far point of 14, 14f
Myopic lens 299
Myopic photoablation treatment, superior nasal decentered 71f
N
Nanosecond lasers 176
Near point 13, 14
Near vision segment 108
Near visual acuity 108, 251
uncorrected 105, 252
Negative cylinder
ablation 204f
patterns 190
Neodymium-yttrium aluminum garnet 176
Nidek laser system 198
Night vision disorder 290
Nomograms, preexisting 124
Nonprogressive disease 165
Non-toric intraocular lens 113
O
Ocular procedures, multiple 258
Ocular viscoelastic device 133
On-axis incisions 231
Ophthalmic surgery 136
Ophthalmic viscoelastic device 119
Ophthalmologic surgery 144
Ophthalmology 113
Optical aberrations 111
Optical coherence tomography 36, 47, 48, 177, 178f, 181, 181f, 299
time-domain 47
Optical power map 32, 32f
Optical signal 48
Optical system 60
Optical zone limits, detection of 34
Oral carbonic anhydrase inhibitor 289
Orbit 4
Orbscan generates information 37
Oxygen free radicals 266
P
Pachymetric map display 41
Pachymetry 48, 70f, 93
less dependence on 174
Pals syndrome 88
Paracentral posterior surface steepening 42f
Pellucid marginal degeneration 30f, 36, 188
Pentacam 38
four-map refractive display of 42f
topography 96f
Peripheral corneal
disease 148
relaxing incisions 81, 128, 138, 147
Peripheral pulses, number of 187
Phaco incisions, right eye 87f
Phacoemulsification 249
Phakic intraocular lens 60, 267, 296, 299, 299f, 306f
posterior chamber 284
Phakic lens 284
Phakic toric intraocular lens 299
Phakoemulsification incision 138
Photic phenomena 108, 112, 251, 259
severe 109
Photoastigmatic refractive keratectomy 60, 195, 199t, 209
Photochemical effect 266
Photokeratoscope 26
Piggyback intraocular lens 249, 255
implantation 254, 258
techniques 258
Pigment deposits 303, 305
Placido
and Scheimpflug topographers 280t
based topographer 47, 66
disk 32
corneal topography 233f
principle 92, 97
reflection 80
system 274
topographer 274, 280
videokeratography 80
patterns, reflection of 29f
technology 67
Plate-haptic multifocal toric intraocular lens 100f
Point deviation, posterior minimum thickness 57
Polymethyl methacrylate 197, 297
non-foldable 99
Poor visual
outcome 182
potential 155
Positive cylinder
ablation 204f
approach 191
patterns 190
Post-cataract surgery 148
Postcorneal transplantation 96
Posterior corneal astigmatism 91, 92, 94-97, 154, 156, 157
measurement techniques 91
Postkeratoplasty 279
astigmatism 244f
management of 240
surgical management of 246
suture-in 241
suture-out 242
Post-keratorefractive surgery 134
Post-laser in situ keratomileusis 262
keratectasia 265, 267
Post-refractive surgery 95, 278
Presbyopia 12, 13
Pseudophakia 231
Pseudophakic ametropias 250
management of 259
Pseudophakic analysis 133f
Pseudophakic intraocular lens 171
designs 99
Pseudophakic measurement 132
intraoperative 132f
Pseudophakic residual refractive errors 259
Pterygia 80
Pterygium surgery 280
Ptosis 145
Punctate epithelial erosions 274
Pupil 143, 302
centered paired arcuate incisions 181f
damage 303
dilation 287
unwanted 301
normal 305
small 123f
Pupillary intraocular lens optic capture 254
Pupillary ovalization, severe 307
Purkinje image 92
Q
Quad map 38
R
Radial keratotomy 69, 174
history of 71f
Randomized controlled trial 102
Reflective surface, spherical 144
Refraction 15, 72, 252, 293
Snell's laws of 31
wavefront 24
adjusted manifest 196
Refractive astigmatic analysis, vector 225t
Refractive corneal
power display map, total 40
surgical procedure 124
Refractive cylinder 22f, 24
manifest 291, 292f
Refractive effect 157
Refractive enhancement 250
procedures 258
Refractive error 137, 272
minor 175
postoperative 145
Zernike optimization of 276
Refractive index 257
Refractive lens exchange 251
surgery 164
Refractive lenticule 150
extraction 213, 214
Refractive map display 40, 41f
Refractive models 252
Refractive multifocal intraocular lens 252
Refractive power 40
loss 159t
maps 31
Refractive report display 43
Refractive surgery 22, 34, 66, 68, 195, 213
Regular astigmatism
classification of 18
correct 182, 238f
Residual astigmatism 108, 113, 139, 142, 154-156, 157, 175, 259
causes of 155b
high risk of 137
management of 154
postoperative 257
treatment 157
algorithm for 158
methods for 157b
Residual corneal tissue 273
Residual myopia, correction of 250
Residual refractive error 252
correction 251t
Residual spherical component, treatment of 189
Retics keratoconus classification 166f
Retina 60, 186, 266
Retinal detachment 142, 307
surgery 113
Retinal image, unequal 305
Retinal tears 256
laser treatment for 113
Riboflavin 265, 266
Rigid gas permeable 145
lenses 241
Root mean square 61, 208
S
Salzmann's nodular degeneration 155
Salzmann's nodules 80
Sanders-Retzlaff-Kraff formula 165
Scanning-slit technology 67
Scar 274
Scheimpflug camera 54
Scheimpflug imaging 232f, 237f
system 274
topographer 275, 280
Scheimpflug maps 238f
Scheimpflug optics 97
Scheimpflug system 48
Scheimpflug technology 80
Scheimpflug tomographer 80, 275
Schwind excimer laser 197
Scleral buckle 69
Scleral incision 139f, 301
types of 140f
Scleral lenses 241f
Scleral tunnel incisions 168
Scleral vessel registration 119
Sclerocorneal incisions 304
Several geometrical parameters, deviations of 57
Shack-Hartmann device 37
Simulated keratometry, calculation of 28
Sirius 44
system, previous studies of 44
tomography 45
Skewed radial axes 231, 238
Slit lamp 176f
assisted preoperative, manual 131
headband 176
standard 129
with toric intraocular lens 159f
Slit-scanning elevation topography device 94f
Small incision cataract surgery 140
Small incision lenticule extraction 150, 213, 214f, 215, 221-223, 223t, 227, 233
advantages of 213
clinical results of 227
limitations of 215
surgery 214f
Small optical zone, enlargement of 275
Snell's law 31, 93
Spectacle 22, 162, 240
best corrected visual acuity 83
correction 71f, 240
independence evaluation 73
lenses 145, 146
Spectral domain 48
Specular topography 28, 34
applications of 31
maps, interpretation of 31
Specular videotopography, general principles of 27
Spherical aberration 62, 273
Spherical ablation, negative 191
Spherical component 234f
Spherical correction 189f
Spherical equivalent 20, 180, 200, 223
mean 108
postoperative 199, 225
Spherical treatment 191
Spherical wavefronts 12
Spherocylindrical ametropia, correct 186
Spherocylindrical lens 19
combinations of 21
Spherocylindrical refraction 264
Spherocylindrical refractive errors 255
Spherocylindrical spectacle lens 17
Spherocylindrical system 66
Stable keratoconus, history of 93
Steep corneal
axis 128
meridian 128
Stenopaic slit 20
Sub-Bowman's layer 177
Subcapsular cataract, anterior 285, 289, 289f
Subconjunctival injection 302
Subluxated iris clip intraocular lens 304f
Sulcoflex intraocular lens 255f
Sulcoflex method 254
Sulcus-to-sulcus distance 286
Surgical keratorefractive procedures 144
Suture
procedures 146
removal of 241f
Sweet spot 85, 86
Symmetric bow tie 63f, 231
Symmetric central corneas 82
Synechiae formation, anterior 303
T
Talbot Moiré interferometry 132
Tangential curvature 30f
Tear
debris 274
film quality 274
Tecnis multifocal toric lens 109
Tecnis ZMT intraocular lens 109
Telecentric keratometry 23
Terrien's degeneration 148
Thermal keratoplasty 269
procedures 263, 267, 268f, 269
techniques 263, 268
Tissue
morphology of 268
sparing 192
Tomographer 23
slit-scanning 92
Topographer 23
Topographic map 38
Topographic measurement, tips for 274b
Topography 67, 70f-72f, 80, 144
guided ablation 279
general considerations 206
results 206
treatment 276f, 279
guided treatment 271, 272, 274, 275, 281
limitations of 280
newer 271
map, preoperative 237f
measurement 274
right eye 105f
Toric bifocal lens 99
Toric calculators 117
Toric contact lenses 22
Toric implantable collamer lens 283, 290
implantation of 285t, 294
Toric intracameral lenses 86
Toric intraocular collamer lenses 238
Toric intraocular lens 22, 33, 89, 99, 118, 121f, 122f, 124f, 128, 139, 141, 154, 157, 159, 231, 238, 245, 283
alignment 130, 154t
maintaining 134
history of 99
implantation 113, 154, 166f
intraoperative alignment of 134
recipients of 113
replacement 157
rotation 157, 159
risk factor for 120, 120f
step-by-step procedure for 161b
step of 117
teaching for 120
technique 121
Toric lenses 17f, 83, 136, 139
alignment of 130, 136
soft 145
Toric monofocal lens 99
Toric phakic intraocular lens 296, 297f, 300, 303, 305
advantages of 298, 298t
disadvantages of 298, 298t
Toric pseudophakic intraocular lenses 99
Toric trifocal intraocular lens 99
implantation of 110f, 111f
Torus 15
Traditional manual techniques 134
Traumatic flap dislocations 150
Treacher Collins syndrome 4
True vision 131f
system 131
U
Ultrasound biomicroscopy 287
Ultraviolet light 262
Urrets-Zavalia syndrome 303
Uveitis 303
acute anterior 306f
V
Variofocals toric intraocular lenses 105
Videokeratoscopes 27
Videokeratoscopic devices 25
Visante, display of 47f
Vision
poor uncorrected 257
recovery of 287
Visual acuity 64, 108, 145, 258, 265, 265t, 279, 293
and safety, spectacle-corrected 291
binocular 112
corrected 121, 142
distance 54, 103, 165, 265, 272, 273
distance 102, 280
optimal 110
postoperative 113, 199
spectacle-corrected 291f
uncorrected 106, 121, 201, 224, 245, 272, 285, 290, 291f
distance 102, 164, 251
Visual correction 279
Visual distortion 273
Visual efficacy, uncorrected 290
Visual function 107
Visual improvement 273
Visual outcomes 191
Visual symptoms 273
treatments reduce 271
Visual tasks 111
Vitamin B2 265
W
Wavefront 60
aberrometry 64, 67
intraoperative 121
guided ablations
general considerations 207
results 207
image quality parameters 62
optimized ablation profiles 187
Weak zonules 155
With-the-rule astigmatism 91
World Health Organization 1
Worsening keratometric readings 269
Wound
healing, secure 146
hydration 134
leakage 303
misalignment 151
Z
Z-axis 56
Zernike coefficients 276
Zernike optimization 276, 276b, 277f
Zernike polynomials 60, 61, 64, 68, 276
decomposition 34
equation 61
image 62
Ziemer ophthalmic systems 92
Zyoptix aberrometer 37
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Chapter Notes

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