Cataract Refractive Error
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options for correction of refractive error following cataract surgeryAhmedAAbdelghany1, 2 and JorgeLAlio3, 4, 5Email authorEye
Refractive Error After Cataract Surgery
and Vision20141:2DOI: 10.1186/s40662-014-0002-2© Abdelghany and Alio; licensee BioMed Central2014Received: 26May2014Accepted: residual refractive error after cataract surgery 13August2014Published: 14October2014 SummaryRefractive errors are frequently found following cataract surgery and refractive lens exchange. Accurate
Post Cataract Surgery Refractive Error
biometric analysis, selection and calculation of the adequate intraocular lens (IOL) and modern techniques for cataract surgery all contribute to achieving the goal of postoperative refractive error after cataract surgery cataract surgery as a refractive procedure with no refractive error.However, in spite of all these advances, residual refractive error still occasionally occurs after cataract surgery and laser in situ keratomileusis (LASIK) can be considered the most accurate method for its correction. Lens-based procedures, such as IOL exchange or piggyback lens what is residual refractive error implantation are also possible alternatives especially in cases with extreme ametropia, corneal abnormalities, or in situations where excimer laser is unavailable. In our review, we have found that piggyback IOL is safer and more accurate than IOL exchange.Our aim is to provide a review of the recent literature regarding target refraction and residual refractive error in cataract surgery. Keywords Cataract surgery Target refraction Residual refractive error Refractive surprise Excimer laser surgery Photorefractive keratectomy Intraocular lens exchange Piggyback lens 1IntroductionCataract removal with Intraocular lens (IOL) implantation is one of the most frequently performed surgical procedures in current clinical practice. Modern microsurgical techniques, new IOL technologies, sophisticated biometry methods, and advanced methods of IOL power calculation allow most cataract patients to regain high-quality vision. The main issue to avoid refractive surprise following cataract surgery is the accuracy of the IOL calculation together with the selection of the appropriate biometric fo
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And Events Ocular Disease Oculoplastics Ophthalmic Product Development Pediatrics Practice Management Public Health Refractive Surgery Research Retina Stem Cells Surgical Education Therapeutics/External Disease EVENTS NEWSLETTER Review Of Ophthalmology Online Retina Online JOBS Find a Job Post a Job Michelle Stephenson, Contributing Editor Published 6 January https://www.reviewofophthalmology.com/article/refractive-surprises-after-cataract-surgery 2014 Refractive Surprises After Cataract Surgery The best treatment depends on the amount of residual http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/modernmedicine/modern-medicine-news/multiple-factors-determine-residual-refr?page=full error. When it comes to refractive surprises after cataract surgery, an ounce of prevention is worth a pound of cure, and surprises can be anticipated in certain patients. "We should anticipate refractive surprises when an eye is extremely myopic or extremely hyperopic, so in very large or very small eyes," says Kevin M. Miller, MD, a professor of clinical ophthalmology refractive error at the Jules Stein Eye Institute at UCLA. "With conventional lens power calculations, even when the appropriate formula is used for extreme myopes and extreme hyperopes, patients can end up hyperopic. We have to adjust our calculations for extreme cases, targeting for a bit of residual myopia. For example, if the SRK/T formula predicts a negative power IOL in axial myopia, I will usually choose the IOL power that targets for -1.5 D of postoperative after cataract surgery myopia, expecting to hit emmetropia by doing so. If the Hoffer Q formula predicts a 38 D IOL in axial hyperopia, I will often choose a 39 or 40 D IOL instead, expecting to achieve emmetropia by doing so." Dr. Miller also anticipates refractive surprises in patients who have previously undergone RK, PRK or LASIK. Additionally, there can be surprises in post-penetrating keratoplasty patients and in cases where the anterior segment of the eye is disproportionately sized compared to the overall length of the eye. However, when refractive surprises occur with no warning after routine cataract surgery, it is important to stay calm. Dr. Miller says the best course of action is to remain the patient's advocate and not to let the situation become adversarial. Colorado Springs-based surgeon Steve Dewey, MD, notes that preoperative IOL counseling can help prepare patients for surprises. "I let the patient know that while this looks like we're playing darts, it's really horseshoes," he says. "We're trying to get patients as close as possible to their goal, but we won't know exactly how close we're going to be until after the surgery. I typically do the nondominant eye first if we are doing both eyes. I tell patients that I can adjust the implant power for the dominant eye and make their vision closer to our target. It
Times Practical Cardiology Urology Times BusinessPractice Management Health Law & Policy Healthcare IT E-Books Practice Management Whitepapers Webinars EDUCATIONCME CPE Careers Contact UsAdvertise About Us Email us / Questions Log In | Register Search this site: SUBSCRIBE: Digital / Print / eNewsletter CONNECT: OphthalmologyTimes Nav Home Refractive Cataract Retina Glaucoma Cornea General Ophthalmology Practice Management Ophthalmology Times EuropeCataract Glaucoma Refractive Retina Supplements TRENDING: Antibiotic Resistance Cataract Surgery Ophthalmic Tech's Community Money Matters UVEITIS Facebook linkedinEmail Increase FontSharebar PREVASA: Drinking Diet Soda May Up Vascular Event ...ASA: Drinking Diet Soda May Up Vascular Event ...Cancer drug combination may increase risk of ...NEXTCancer drug combination may increase risk of ... OphthalmologyTimesOphthalmology Multiple factors determine residual refractive error Base intervention on benefits of surgery versus spectacles, suggests ophthalmologist September 15, 2010 By Cheryl Guttman Krader Dr. Arbisser Bettendorf, IA—Attention to a host of preoperative and intraoperative factors can minimize the risk of residual refractive error (RRE) after cataract surgery, but when a refractive surprise occurs, there are also multiple variables to consider before deciding on intervention, said Lisa B. Arbisser, MD. According to national benchmarks, cataract surgeons should aim for the achieved refraction to be within 0.5 D of the target about 55% of the time and within 1.0 D in about 85% of cases. Dr. Arbisser said that, in her hands and based on analysis of data for all comers, she well exceeds these targets with 85% of eyes achieving a refraction ±0.5 D of the target and 99.2% having a RRE <1.0 D. "However, we should all strive to do even better," said Dr. Arbisser, clinical adjunct associate professor, Moran Eye Center, University of Utah, Salt Lake City, and a private practitioner in Bettendorf, IA. Preventive strategies Figure 1 Topography from initial evaluation in a patient with cataract and Salzman's nodular dystrophy, before treatment. Figure 2 shows the same eyes after treatment. Be certain that astigmatism is regular and not due to basement membrane disease before choosing a toric lens. Inaccurate axial length measurement is an important cause of RRE, although this problem