We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byHayden Willmott
Modified about 1 year ago
1 Uday Devgan MD Los Angeles You can download my slides for free at www.UdayDevgan.com
2 Abbott Medical Optics: consultant, research Accutome Inc: speaker Alcon Laboratories: stockholder Allergan: consultant, speaker, research funding Bausch & Lomb: consultant, research funding Gerson Lehman Group: consultant Haag-Streit: speaker Hoya Surgical Optics: consultant, speaker Inspire Pharma: stockholder (former), consultant Ista Pharma: consultant, speaker, stockholder iTherapeutix: research funding, travel support Optos Inc: speaker Renaissance Surgical: stockholder Sirion Therapeutics: consultant Specialty Surgical: stockholder Staar Surgical: consultant (former) Zeiss / Carl Zeiss Meditec: speaker This presentation represents the speaker’s professional experience. Uday Devgan MD disclosures
3 Astigmatism Must Be Addressed
4 How close do I have to be for excellent visual results with the Crystalens? 1.plano +/- 0.50 D< 0.50 D cyl 2.plano +/- 1.00 D< 1.00 D cyl 3.my patients have such dense cataracts they are happy even if I leave them aphakic. Question #1
5 Confirmed with SurgiVision Data
6 Binocular: 20/20 dist, 20/18 int, 20/25 near if there is minimal cylinder
7 Perfect Plano Quick, where’s my camera?
8 1D Residual Astigmatism (Far)
9 1D Residual Astigmatism (Near)
10 Nailing +/- 0.50 D for Both Sphere and Cylinder Is Important
12 Effective Lens Position is Critical The A-constant assumes a proper posterior vault of the Crystalens
13 Incisions Must be 100% Sealed
15 The Difference Between Sad & Happy +1.00 – 2.00 x 090 SE = Plano +0.25 – 0.50 x 090 SE = Plano
16 0 +0.50 cyl-0.50 cyl Crystalens HD Crystalens AO Is the AO More Forgiving than the HD?
17 Measure & Treat the Astigmatism
18 How do you determine the amount of pre-op astigmatism that needs to be fixed? 1.IOL Master / Lenstar 2.corneal topography 3.manual keratometry 4.manifest refraction Question #2
19 Pre-Op Corneal Cylinder Ignore the refraction cylinder Look at the Corneal cylinder
20 Topography to Check Symmetry
21 Weed-out Inappropriate Patients
22 Address the Astigmatism Topography Effect of your incisions? LRI: Limbal Relaxing Incisions
23 What’s the effect of your incision? Most clear K incisions = Flattening of about 0.50 D 44.25 43.75 Pre-op K: 44.50 x 030 43.50 x 120
24 LRIs can reduce/eliminate K cyl BEFORE AFTER Thank you to Kevin Miller MD for this slide.
25 Factor in your Phaco Incision: Figure 1 © 2009 Uday Devgan MD
26 BEFORE SURGERY 44.75 x 90 44.25 x 180 © 2009 Uday Devgan MD
27 AFTER PHACO INCISION (0.5 D of flattening at 180) 45.00 x 90 44.00 x 180 © 2009 Uday Devgan MD
28 WITH LRI DONE FOR 1 DIOPTER AT 90 44.50 x 90 44.50 x 180 © 2009 Uday Devgan MD
29 LRIs are placed in the peripheral clear cornea by tracing along the fixation ring. © 2009 Uday Devgan MD
30 Post-Op Astigmatism
31 What are the causes of post-op astigmatism? 1.irregular ocular surface 2.residual corneal astigmatism 3.IOL tilt or shift from capsular bag contraction / fibrosis 4.all of the above Question #3
32 Irregular Corneas (uncommon)
33 Residual Refraction (common) Not Enough Effect From Your LRI
34 Capsule Issues Causing IOL Shift
35 Small Rhexis / Phimosis Hyperopic Shift and Induced Cylinder
36 Posterior Capsule Fibrotic Bands Myopic Shift and Induced Cylinder
37 After YAG of Capsular Striae
38 Poor Rhexis = Poor Result All 4 footplates must be at the capsular bag equator One arm in the sulcus will cause IOL tilt
39 If you remember just ONE thing…
40 NAIL PLANO Sphere & Cylinder within 0.50 D of plano
Factors which Influence Accommodative Amplitude in Crystalens HD Patients Uday Devgan, MD, FACS Devgan Eye Surgery, Los Angeles, CA FINANCIAL DISCLOSURES:
Outcomes Update for an Aspheric Accommodating IOL John A. Hovanesian, M.D. Clinical Instructor, UCLA Jules Stein Eye Institute Harvard Eye Associates,
1 Bimanual Microincision Cataract Surgery with Stellaris Advanced Flow Module Mark Packer, MD, FACS Clinical Associate Professor Oregon Health & Science.
Comparison of Visual Outcomes With Toric IOL and With Limbal Relaxing Incisions in Cataract Surgery Eriko Fukuyama, MD Fukuyama Eye Clinic Fukuoka, Japan.
Retrospective Comparison of 3177 Eyes Implanted with Presbyopic IOLs Carlos Buznego MD Elizabeth A. Davis MD, FACS Guy M. Kezirian MD, FACS William B.
Mark Packer, MD Financial Disclosure Consultant –Advanced Medical Optics, Inc. –Advanced Vision Science, Inc. –Bausch & Lomb, Inc. –Candeo Clinical/Science.
M. NOURI FESHARAKI MD In modern phaco surgeons no longer seek to avoid inducing ast. but rather must address to reduce significant pre-existing cylinder.
In modern phaco surgeons no longer seek to avoid inducing ast. but rather must address to reduce significant pre-existing cylinder. Patients have now.
Corneal shape and corneal aberrations after MicroIncision Cataract Surgery (MICS) NOCHEZ Y, BUREL B, MAJZOUB S, PISELLA PJ C.H.U.
Intraoperative Aberrometry Mark Packer, MD, FACS Clinical Associate Professor Oregon Health & Sciences University.
Clinical Outcomes Post AcrySof Toric IOL Implantation In 231 Consecutive Eyes Johnny L. Gayton, MD, FSEE Eyesight Associates 216 Corder Road 216 Corder.
Cataract Surgery Using Biaspheric IOLs in Patients With Corneal Irregularities James P. Gills, MD St. Luke’s Cataract & Laser Institute Tarpon Springs.
Ray T. Oyakawa, M.D., M.B.A. ASCRS Boston 2010 No financial interests Vector Analysis for Astigmatism Management in Cataract Surgery.
Managing the Refractive “Surprise” After Toric IOL Placement Managing the Refractive “Surprise” After Toric IOL Placement Brad H Feldman, MD Derek DelMonte,
Presented by: Ray T. Oyakawa, M.D. Sharper Vision Centers A MEDICAL GROUP Vector-Adjusted NAPA Limbal Relaxing Incision at the time of Cataract Surgery.
1 Clinical Performance of the Crystalens® AO Guy M. Kezirian, MD, FACS.
بسم اللة الرحمن الرحيم. Limbal relaxing incisions versus penetrating limbal relaxing incisions for the management of astigmatism in cataract surgery Sara.
Small Wound Leaks are Associated with Myopic Surprises in Cataract Surgery John A. Hovanesian, M.D. Clinical Instructor, UCLA Jules Stein Eye Institute.
Justin Charton, MD, Preston H. Blomquist, MD, Nalini K. Aggarwal, MD, James P. McCulley, MD University of Texas Southwestern Department of Ophthalmology.
J. E. “Jay” McDonald, II M.D. McDonald Eye Associates Fayetteville, Arkansas Financial disclosure: Bausch and Lomb – Consultant; Addition.
REFRACTIVE ASPECTS OF CATARACT SURGERY. OPTICAL CORRECTIONS AFTER CATARACT EXTRACTION.
Investigation of Multifocal Toric IOLs to Compensate for Corneal Astigmatism and to Provide Near, Intermediate, and Distance Vision José L. Rincón, MD.
Practice Styles and Preferences of US ASCRS members – 2009 Survey David Leaming MD Palm Springs, CA In 2009 the survey went out electronic.
Comparison of visual function following piggyback implantation of Acrysof ReSTOR intraocular lenses with Tecnis multifocal ZM900 intraocular lenses. Rodrigo.
Multifocal Intraocular Lenses Abdullah Al-assiri Mansour Farooqui Abdulrahman Al-Muammar Saudi Ophthalmology Meeting 2009.
The Effect of Corneal Anterior Surface Eccentricity on Astigmatism after Cataract Surgery Choul Yong Park MD 1 Sung Jun Lee MD 1 Prabjot Channa MD 2 Roy.
I have no financial interest in any devices or techniques discussed in this presentation.
M. Allison Roensch, MD, Preston H. Blomquist, MD, Nalini K Aggarwal, MD, James P. McCulley, MD Department of Ophthalmology University of Texas Southwestern.
Phacoemulsification in eyes with previous anterior chamber phakic IOL surgery Walton Nosé, MD, PhD 1,2 Adriana dos Santos Forseto, MD 1 Mariana Ávila,
1 Comparison of Distance Image Quality with Accommodating and Multifocal Aspheric Presbyopia-Correcting IOLs John F. Doane, M.D., F.A.C.S. Discover Vision.
Correction of presbyopia by central biaspheric multifocal LASIK (PRESBYMAX ® ) in myopic patients. Jorge L. Alió MD, PhD, Dolores Ortiz PhD, Esperanza.
Evaluation & Surgical Correction of Astigmatism Jean Luc Febbraro MD Rothschild Foundation Paris France
Multifocal and Toric IOLs: An Update on the Resident Experience M. Allison Roensch, MD, Preston H. Blomquist, MD, Nalini K Aggarwal, MD, Justin W. Charton,
INTRAOCULAR LENS (IOL) BASIC MONOFOCAL LENS ASTIGMATISM CORRECTION SURGERY or LENS CRYSTALENS AO TRULIGN TORIC RESTOR TECNIS MULTIFOCAL PRESBYOPIA CORRECTIONNo.
Post-LASIK Intraocular Lens Power Adjustment Nomogram Joseph Diehl Kevin Miller, MD Jules Stein Eye Institute, David Geffen School of Medicine.
9-Month Results after Implantation of a new accommodative IOL that works with one focus Mark Tomalla M.D.* Clinic for Refractive and Ophthalmic Surgery,
An Epidemic of Dislocated IOLs? Garth Stevens Jr. MD Eye Care Center of Virginia Mary Washington Eye Care Center.
Hyun Seung Kim, M.D. Department of Ophthalmology, St. Mary’s hospital, The Catholic University of Korea Changes in Astigmatism After Clear Corneal Temporal.
Long-Term Follow-Up of Toric Intraocular Lens Implantation for Keratoconus Alejandro Navas, MD, MSc, Martha Jaimes, MD, Jesús Cabral, MD, Arturo Ramirez.
Eastwood Eye Surgery Toric and Modern IOL Technology Dr Gagan Khannah Ophthalmic Surgeon Eastwood Eye Surgery Sydney Eye Hospital Stamford Grand 3 rd May.
1 Cataract Surgery Stephen G. Slade MD, FACS. 2 Financial Disclosure Alcon, AMO, B&L Consultant, Clarity, NuLens, RVO, Technolas 2 This presentation represents.
Correction of Astigmatism with Toric IOL After Previous RK By Chirag R. Shah MD; H. V. Gimbel MD, MPH; A. Dardzhikova MD Authors have no financial interest.
John P Berdahl M.D.* David R. Hardten M.D., F.A.C.S.* *No relevant financial disclosures.
Sonia Yoo, MD 1 Fernanda Piccoli, MD 1 Artur Schmitt, MD 1 Takeshi Ide, MD 1 Tsontcho Ianchulev, MD 2 Authors have no financial interest in this subject.
Early capsular bag contraction with haptic dislocation following implantation of a flexible hydrophilic acrylic “psuedoaccomodating” IOL Nigel Morlet FRACS.
Bilateral phacoemulsification and intraocular lens (IOL) implantation for bilateral corneal ectasia after photorefractive keratectomy (PRK) Department.
Astigmatism management with toric intraocular lenses in cataract patients Adriano Guarnieri 1-2, Luis W. Lu 3-4, Alfonso Arias- Puente INCIVI, Madrid,
Clinical evaluation of foldable acrylic phakic IOL (fP) implantation ASCRS, San Diego, 2011 A.John Kanellopoulos, MD Professor NYU Medical School, NY Director,
1 Comparison of bitoric with monotoric laser in situ keratomileusis for the correction of myopic astigmatism with the Nidek EC-5000 Laser. By Mohamed Abdul-Rahman.
Results of Collagen Crosslinking followed by posterior chamber toric implantable collamer lens implantation in patients with Keratoconus & High Myopia.
© 2017 SlidePlayer.com Inc. All rights reserved.