Máster Técnicas en Cirugía Oftálmica

Section 1: Anterior Chamber
1. Cyclodialysis Cleft in Anterior Chamber Area 3
Evan Benjamin Dreyer, Norman M Aquino
• Indications and Contraindications 3
• Preoperative Evaluation 3
• Surgical Techniques 3
• Evaluation 5
• Management 5
2. Epithelial Downgrowth 8
J James Rowsey
• Indications and Contraindications 8
• Recognition and Diagnosis of Epithelium in the Anterior Segment 8
• Predisposing Factors to Epithelial Downgrowth 9
• Factors Opposing Epithelial Downgrowth 9
• Endothelial Inhibition 10
• Epithelial Downgrowth after Eye Surgery 10
• Surgical Techniques: Epithelial Downgrowth 10
• Eighteen Millimeter Corneoscleral Transplants for Epithelial Downgrowth 13
• Technical Alternatives and Pitfalls: Surgery for Epithelial Downgrowth 17
• Rehabilitation 17
• Results 17
• Discussion 18
3. Foreign Body of Anterior Chamber 20
Majed Alkharashi
• Clinical Thought Processes 20
• Indications and Contraindications 22
• Surgical Techniques 22
• Closure Technique 24
• Technical Alternative and Pitfalls 25
• Rehabilitation 25
4. Intraocular Epithelial Cysts 27
F Hampton Roy
• Clinical Considerations 27
Contents
xx Master Techniques in Ophthalmic Surgery • Indications and Contraindications 28
• Surgical Techniques 28
• Photocoagulation Technique 30
5. Postoperative Flat or Shallow Anterior Chamber 32
Lama A Al-Aswad, George A Cioffi
• Wound Leaks 32
• Glaucoma Surgery 33
• Choroidal Detachments 33
• Pupillary Block 34
• Malignant Glaucoma or Aqueous Misdirection Syndrome 34
• Indications and Contraindications 35
• Surgical Techniques 35
Section 2: Choroid
6. Angioid Streaks 41
F Hampton Roy
• Indications and Contraindications 42
• Surgical Techniques 42
• Technical Alternatives and Pitfalls 43
• Rehabilitation 44
7. Choroidal Detachment 47
Carlos W Arzabe, Sulaiman M Alsulaiman, Abdulaziz Adel Al Rushood, Carmen Demetrio, J Fernando Arevalo
• Medical Management 47
• Postoperative Management 51
• Complications 51
• Uveal Effusion Syndrome 52
• Differential Diagnosis 52
• Treatment 52
• Prognosis 53
8. Choroidal Neovascular Membranes 55
Abdulaziz Adel Al Rushood, Sulaiman M Alsulaiman, Carlos W Arzabe, J Fernando Arevalo
• Indications and Contraindications 55
• Fluorescein Angiography 55
• Optical Coherence Tomography 56
• New Techniques for Treating Choroidal Neovascular Membrane 59
• Diagnosis and Initiation of Therapy 59
• Role of Optical Coherence Tomography in Antiangiogenic Treatment Protocols 60
Contents xxi
9. Expulsive Suprachoroidal Hemorrhage 63
Sulaiman M Alsulaiman, Carlos W Arzabe, Abdulaziz Adel Al Rushood, Carmen Demetrio, J Fernando Arevalo
• Etiology 63
• Clinical Features 64
• Prevention 64
• Surgical Techniques 66
• Medical 67
10. Posterior Uveal Melanoma 69
Connie J Chen, James T Handa
• Surgical Application of Radioactive Plaque 69
• Charged Particle Radiation 71
• Local Resection 73
• Enucleation 73
• Orbital Exenteration 74
• Nonsurgical Approaches 74
Section 3: Conjunctiva
11. Conjunctival Lacerations 79
F Hampton Roy
• Indications and Contraindications 79
• Surgical Techniques 80
• Alternatives and Pitfalls 81
• Rehabilitation 82
12. Conjunctival and Corneal Melanotic Lesions 83
Woodford S Van Meter, Douglas G Katz, Arpan Bachhawat
• Clinical Thought Processes 83
• Indications and Contraindications 83
• Surgical Techniques 86
• Postoperative Care 87
• Technical Alternatives 87
13. Pterygium 90
Italo M Astudillo, Kenneth R Kenyon, Peter A Rapoza
• Indications and Contraindications 90
• Surgical Techniques 91
• Surgical Anatomy of the Conjunctiva 91
• Pterygium Resection Techniques 91
• Conjunctival Grafts and Flaps 92
xxii Master Techniques in Ophthalmic Surgery • Adjunctive Therapy 94
• Complications 95
• Future 97
Section 4: Cornea
14. Band Keratopathy 101
Nicholas J Butler, Yassine J Daoud
• Pathogenesis 101
• Disease Associations 102
• Indications and Contraindications 103
• Complications 105
15. Bullous Keratopathy in Pseudophakia 107
Vikas Mittal
• Preoperative Assessment and Contraindications 107
• Procedure 107
• Postoperative Medications 112
• Complications and Management 113
16. Chemical and Thermal Burns of the Ocular Surface 114
Dasa V Gangadhar, Kenneth R Kenyon, Sundeep K Kasi
• Pathophysiology 114
• Classification of Severity 114
• Medical Management 115
• Surgical Therapy 115
• Adjunctive Therapies 118
• Surgical Variations and Alternatives 118
• Keratoplasty and Keratoprosthesis 119
17. Conjunctival and Corneal Intraepithelial Neoplasia 121
Frederick W Fraunfelder
• General Features 121
• Indications and Contraindications 121
• Technical Alternatives and Pitfalls 123
18. Corneal Laceration or Perforation 125
Vikas Mittal
• Evaluation 125
• Management 126
• Technical Alternatives 129
• Rehabilitation 129
Contents xxiii
19. Corneal Cysts 132
Jim Liu
• Clinical Presentation 132
• Indications and Contraindications 132
• Surgical Techniques 134
20. Descemet’s Membrane Detachment 136
F Hampton Roy
• Overview 136
• Indications and Contraindications 136
• Surgical Techniques 136
• Dressings and Immediate Postoperative Care 138
• Technical Alternatives 138
• Potential Pitfalls 138
21. Keratoconus 140
John D Au, Thomas L Steinemann
• Clinical Background 140
• Surgical Indications and Contraindications 140
• Treatment of Corneal Hydrops 146
22. Pellucid Marginal Degeneration 148
Rory Meyer, Yassine Daoud
• Indications and Contraindications 148
• Technical Alternatives and Pitfalls 150
• Rehabilitation 151
23. Recurrent Corneal Erosion 152
Tayyeba K Ali, David B Warner
• Clinical Findings 152
• Medical Management 152
24. White Cornea 158
Peter R Kastl
• Differential Diagnosis of the White Cornea 158
• Diagnosis of Hidden Pathology 158
• Indications and Contraindications 159
• Surgical Techniques 159
25. Anterior Stromal Opacity 160
Lesile T Pham, Dasa V Gangadhar, Kenneth M Goins, Michael D Wagoner, Kenneth R Kenyon
• Indications and Contraindications 160
• Surgical Techniques 163
• Technical Alternatives and Pitfalls 164
xxiv Master Techniques in Ophthalmic Surgery Section 5: Extraocular Muscles
26. Abducens (Sixth Nerve) Paralysis 171
Derek T Sprunger, Kathryn M Haider
• Indications and Contraindications 172
• Surgical Techniques 173
• Technical Alternatives and Pitfalls 174
• Rehabilitation 175
27. Acquired Nonaccommodative Esotropia 177
Arun Verma
• Indications and Contraindications 177
• Surgical Techniques 177
• Recession of the Medial Rectus Muscle 179
• Resection of the Lateral Rectus Muscle 181
• Postoperative Care 183
• Rehabilitation 183
28. A-Pattern Esotropia 185
Stephen P Christiansen
• Indications and Contraindications 186
• Surgical Techniques 186
29. A-Pattern Exotropia 191
Julia L Stevens
• Clinical Findings 191
• Indications and Contraindications 191
• Surgical Techniques 192
• Technical Alternatives 195
30. Basic Exotropia 197
F Hampton Roy
• Etiology 197
• Evaluation 197
• Therapy 197
• Precautions 198
• Surgical Choices 199
• Anesthesia 199
• Surgical Techniques 200
• Surgical Complications 203
31. Brown’s Syndrome 206
F Hampton Roy
• Clinical Background 206
Contents xxv
• Indications and Contraindications 206
• Choice of Procedure 207
• Surgical Technique 207
• Operative Procedure 207
• Pitfalls and Pearls 209
32. Congenital Fibrosis of the Extraocular Muscles 211
F Hampton Roy
• Indications and Contraindications 211
• Surgical Techniques 211
33. Convergence Insufficiency 214
Malcolm L Mazow
• Diagnosis 214
• Pitfalls of Diagnosis 215
• Nonsurgical Treatment 215
• Indications and Contraindications 215
• Technical Alternatives and Pitfalls 218
• Rehabilitation 218
34. Dissociated Vertical Deviation 221
Brita S Deacon, K Camille Dimiceli
• Indications and Contraindications 221
• Surgical Techniques 221
35. Double Elevator Palsy 227
Edward L Raab
• Case Identification 227
• Indications and Contraindications 230
• Choice of Operation 230
• Surgical Technique 230
• Technical Alternatives and Pitfalls 232
36. Duane’s Retraction Syndrome 235
A Henry Thomas
• Indications and Contraindications 235
• Etiology 235
• Treatment 236
• Surgical Techniques 236
37. Congenital ‘Essential’ Infantile Esotropia 238
Eugene Helveston
• Terminology 238
• Timing of Onset of the Esodeviation 238
• Etiology 239
xxvi Master Techniques in Ophthalmic Surgery • The Clinical Picture 239
• The Significance of Nystagmus 239
• Patient Presentation 240
• Work-Up 240
• The Role of Glasses 241
• Amblyopia 241
• The Oblique Muscles 242
• The Treatment of Congenital Esotropia 243
• The Timing of Surgery 243
• Surgical Technique 244
• For the Future 249
38. Intermittent Exotropia 253
Brita S Deacon, K Camille Dimiceli
• Expectations 253
• Indications and Contraindications 253
• Surgical Techniques 253
• Undercorrections 255
• Overcorrections 256
39. Nystagmus 258
F Hampton Roy
• Classification of Nystagmus 258
• Diagnostic Evaluation of a Patient with Nystagmus 261
• Treatment of Nystagmus 261
40. Oculomotor (Third-Nerve) Paralysis 263
F Hampton Roy, Helena Roy
• Indications and Contraindications 263
• Surgical Techniques 264
• Technical Alternatives and Pitfalls 266
• Rehabilitation 266
41. Restrictive Strabismus 268
Mary Ellen Hoehn
• Case Identification 270
• Indications and Contraindications 271
• Choice of Operation 271
• General Surgical Guidelines for Restrictive Strabismus 272
• Approach to the Extraocular Muscles with a Discussion of Alternatives and Pitfalls 272
42. Superior Oblique Myokymia 276
Earl A Palmer
• Indications and Contraindications 276
Contents xxvii
• Surgical Techniques 276
• Rehabilitation 278
43. Superior Oblique Palsy 280
David A Plager
• Thought Processes 280
• Making the Surgical Plan 281
• Indications and Contraindications 282
• Surgical Techniques 282
• Technical Alternatives and Pitfalls 285
44. V-Pattern Esotropia 287
F Hampton Roy
• Clinical Findings 287
• Indications and Contraindications 287
• Surgical Techniques 288
• Technical Alternatives 290
45. V-Pattern Exotropia 292
F Hampton Roy
• Clinical Thought Processes 292
• Indications and Contraindications 292
• Surgical Techniques 293
• Myectomy 295
• Technical Alternatives and Pitfalls 296
• Surgical Techniques 296
• Complications 297
Section 6: Eyelids
46. Ankyloblepharon 301
Gary S Lissner, Amy Lin
• Thought Processes 301
• Indications and Contraindications 302
• Surgical Techniques 302
• Pitfalls 304
47. Blepharophimosis 306
Wade Brock
• Clinical Features 306
• Indications and Contraindications 306
• Technical Alternatives and Pitfalls 310
xxviii Master Techniques in Ophthalmic Surgery 48. Chalazion 313
F Hampton Roy, Jan Logan Eyre
• Clinical Thought Process 313
• Indications and Contraindications 313
• Surgical Techniques 313
• Technical Alternatives and Pitfalls 315
• Rehabilitation and Postoperative Treatment 315
49. Dermatochalasis 317
John Nguyen, John Pemberton, Abraham Park, Jie Gao
• Patient Evaluation 317
• Surgical Techniques 319
50. Ectropion 326
Alejandra A Valenzuela
• Physiopathology and Clinical Examination 326
• Surgical Techniques 326
• Involutional Ectropion 326
• Mechanical Ectropion 329
• Paralytic Ectropion 329
51. Entropion 331
Eric A Steele, Roger A Dailey
• Indications and Contraindications 331
• Surgical Techniques 331
• Technical Alternatives and Pitfalls 332
• Rehabilitation 332
52. Epicanthus 334
Alejandra Valenzuela
• Indications and Contraindications 334
• Surgical Techniques 335
53. Everted Punctum 340
John D Pemberton, Maria Hester
• Nonsurgical 340
• Surgical Techniques 340
54. Eyelid Coloboma 343
John D Bullock, Ronald E Warwar
• Indications and Contraindications 343
• Surgical Techniques 343
55. Floppy Eyelid Syndrome 346
F Hampton Roy
• Indications and Contraindications 347
Contents xxix
• Surgical Techniques 347
• Anatomic Considerations 348
• Procedure 348
56. Lagophthalmos 352
Inci Dersu
• Indications and Contraindications 352
• Selection of Patients 353
• Surgical Techniques 353
57. Lid Laceration and Avulsions 357
Bradley Thuro, F Hampton Roy
• Indications and Contraindications 357
• Anatomy 357
• Surgical Techniques 358
• Procedure Specifics 359
• Alternatives and Pitfalls 363
• Rehabilitation 363
58. Lid Retraction 365
F Hampton Roy
• Evaluation 365
• Eyelid Anatomy 365
• Indications and Contraindications 366
• Treatment Alternatives and Pitfalls 369
59. Lid Tumors 372
Bradley A Thuro, F Hampton Roy
• Surgical Techniques 372
60. Madarosis 377
Herbert J Glatt, Allen M Putterman
• Indications and Contraindications 377
• Therapy 377
• Surgical Techniques 378
61. Marcus Gunn Jaw-Winking Syndrome 380
F Hampton Roy
• Indications and Contraindications 380
• Surgical Techniques 381
62. Melanocytic Lesions of the Eyelids 387
Joshua Hardin, Thomas C Cannon
• Indications and Contraindications 387
• Benign Nevus 387
xxx Master Techniques in Ophthalmic Surgery • Surgical Techniques 388
• Malignant Melanocytic Lesions 390
63. Orbital Fat Herniation 401
F Hampton Roy
• Preoperative Evaluation 401
• Indications and Contraindications 401
• Surgical Techniques 401
• Technical Alternatives 404
• Technical Alternatives and Pitfalls 405
• Rehabilitation 406
64. Ptosis 407
Roxana Rivera-Michlig, Uma M Sachdeva
• Congenital Ptosis 407
• Myogenic Ptosis 408
• Aponeurotic Ptosis 409
• Neurogenic Ptosis 409
• Mechanical Ptosis 409
• Apparent Ptosis 409
• Indications and Contraindications 409
• Surgical Techniques 410
65. Kohn-Romano Syndrome (Blepharophimosis Syndrome) 417
John Pemberton, Eddie Mengarelli
• Surgical Techniques 417
66. Symblepharon 423
David B Warner
• Pathogenesis and Indications for Repair 423
• Nonsurgical and Surgical Prevention 423
• Reconstruction Techniques 424
67. Trichiasis 429
Kasra Eliasieh
• Indications and Contraindications 430
• Surgical Techniques 430
• Indications and Contraindications 432
68. Xanthelasma 438
Inci Dersu
• Histology 438
• Lipid Biochemistry 438
• Associated Diseases 439
• Indications and Contraindications 439
Contents xxxi
Section 7: Globe
69. Anophthalmos 443
Fatemeh Rajaii, Roxana Rivera-Michlig
• Congenital Anophthalmos 443
• Acquired Anophthalmos 446
• Orbital Implant Migration, Extrusion and Exposure 448
• Socket Contracture 450
70. Combined Anterior and Posterior Segment Trauma 454
Ferenc Kuhn, Robert Morris, C Douglas Witherspoon
• Evaluation 454
• Surgical Planning 455
• Postoperative Care 461
• Technical Alternatives 461
• Complications and their Management 461
• Prognosis and Results 461
71. Blind-Painful Eye 463
Jessica Chang, Farhan Merali, Fang Ko, Valliammai Muthappan, Nicholas Mahoney
• Modes of Treatment 463
72. Endophthalmitis 473
Robert E Morris, Charles L Clark, Mathew R Sapp, Matthew H Oltmanns, Ferenc Kuhn
• Indications and Contraindications 476
• Surgical Techniques 477
• Technical Alternatives and Complications 482
• Rehabilitation 483
73. Global Traumatic Rupture 485
F Hampton Roy
• Indications and Contraindications 485
• Specific Diagnostic Clinical Clues 486
• Tests that Aid in Diagnosis 487
• Prognosis 487
• Surgical Techniques 488
74. Severe Ocular Surface Trauma 489
Christina R Prescott
• Preoperative Considerations 489
• Surgical Options 489
• Surgical Techniques 490
• Alternative Therapy 494
• Rehabilitation 494
xxxii Master Techniques in Ophthalmic Surgery Section 8: Intraocular Pressure
75. Encapsulated Filtering Bleb 499
Paul N Schacknow
• Indications and Contraindications for Restoration of Filtration through Encapsulated Bleb 500
• Therapy 500
• Surgical Techniques 501
76. Childhood Glaucoma 506
Sarwat Salim
• Preoperative Considerations for Goniosurgery 508
• Goniotomy 508
• Trabeculotomy 510
• Complications of Goniosurgery 511
• Immediate Postoperative Care after Goniosurgery 511
• Rehabilitation and Extended Postoperative Care after Goniosurgery 511
• Trabeculectomy 511
• Nonpenetrating Surgery 512
• Glaucoma Drainage Devices 512
• Cyclodestructive Procedures 512
77. Primary and Secondary Closed-Angle Glaucoma 515
Manuel José Justiniano, José Justiniano Talavera, Carlos Walter Arzabe
• Classification 515
• Primary Closed-Angle Glaucoma 515
• Secondary Closed-Angle Glaucoma 517
78. Primary and Secondary Open-Angle Glaucoma 522
Manuel José Justiniano
• Open-Angle Glaucoma 522
• Laser Trabeculoplasty 522
• Indications and Contraindications 523
• Preoperative Care 523
• Postoperative Care 524
• Filtering Surgery for Open-Angle Glaucoma 524
• Indications and Contraindications 525
• Preoperative Care 525
• Surgical Techniques 526
• Final Steps 530
• Complications 531
Contents xxxiii
79. Elevated Intraocular Pressure after Filtering Surgery 534
Sarwat Salim, Sean Lanchulev
• Elevated Intraocular Pressure and Deep Anterior Chamber 534
• Elevated Intraocular Pressure and Shallow or Flat Anterior Chamber 538
80. Cataract in the Glaucomatous Eye 543
Malik Y Kahook, Joel S Schuman
• Indications and Contraindications 543
• Special Considerations 543
• Surgical Options 543
• Surgical Techniques 544
• Postoperative Care 547
81. Glaucoma Surgery with Fugo Blade 551
Daljit Singh, Kiranjit Singh
• The Myth of Guarded Surgery 551
• An Ideal Bleb 552
• Fugo Blade 556
• Microtrack Filtration According to Kiranjit 560
• Fugo Blade Glaucoma Surgery in Different Situations 566
Section 9: Iris and Ciliary Body
82. Iris Cysts 573
F Hampton Roy
• Preoperative Considerations 573
• Indications and Contraindications 573
• Surgical Techniques 574
83. Iris Laceration and Iridodialysis 581
F Hampton Roy
• Indications and Contraindications 581
• Surgical Techniques 581
• Surgical Techniques 583
84. Iris Melanoma 586
F Hampton Roy
• Indications and Contraindications 586
• Surgical Techniques 586
• Fine-Needle Aspiration Biopsy 587
• Management of Secondary Glaucoma 588
xxxiv Master Techniques in Ophthalmic Surgery 85. Iris Prolapse 590
Stephen S Lane
• Postoperative Iris Prolapse 590
• Indications and Contraindications 591
• Surgical Techniques 591
• Intraoperative Iris Prolapse 593
86. Intermediate Uveitis/Pars Planitis 595
Eric Singman, Theresa Gan Leung
• Overview of Therapy 595
• Ocular Therapy 595
• Systemic Therapy 597
• Surgical Therapy 597
87. Rubeosis Iridis 601
F Hampton Roy
• Clinical Aspects 601
• History and Physical Examination 601
• Indications and Contraindications 601
• Laboratory Evaluation 602
• Indications and Contraindications for Treatment 602
• Postoperative Course 603
88. Irregular Pupil 605
Joshua Ney, Robert P Liss
• Surgical Indications and Contraindications 605
• Surgical Techniques 606
Section 10: Lacrimal System
89. Congenital Lacrimal System Anomalies 615
R Scott Lowery
• Background and Embryology 615
• Signs and Symptoms 616
• Indications and Contraindications for Treatment 616
• Surgical Techniques 616
90. Dacryoadenitis 619
R Scott Lowery
• Presentation 619
• Frequency 619
• Differential Diagnosis 619
• Evaluation 620
• Indications, Contraindications and Treatment 620
Contents xxxv
91. Dacryocystitis 622
Grant D Gilliland, John N Harrington • Epidemiology 622 • Anatomy 622 • Clinical Manifestations 623 • Etiology 624 • Histology 625 • Diagnosis 625 • Differential Diagnosis 625 • Indications and Contraindications 626 • Anesthesia 626 • Surgical Techniques 626 • Postoperative Care 627 • Contraindications for Surgery 628 • Prognosis 628
92. Dacryolith 631
F Hampton Roy • Indications and Contraindications 631 • Surgical Techniques 632 • Alternatives and Pitfalls 634 • Rehabilitation 635
93. Lacrimal Gland Tumors 637
F Hampton Roy • Clinical Evaluation 637 • Indications and Contraindications 637 • Surgical Techniques 638
94. Lacrimal Hypersecretion 641
Chris Thiagarajah, Jay M Lustbader • External Diseases 641 • Eyelid Malpositioning 642 • Lacrimal System Abnormalities 642 • Indications and Contraindications 642 • Surgical Techniques 643
95. Lacrimal Hyposecretion 646
Aruoriwo M Oboh-Weilke, Jay M Lustbader • Classification of Dry Eye 646 • Indications and Contraindications 647 • Medical Management 647 • Surgical Techniques 647 • Punctal Occlusion 648
xxxvi Master Techniques in Ophthalmic Surgery 96. Lacrimal Laceration 653
R Patrick Yeatts, Andrew Ting
• Anatomy 653
• Mechanism of Injury 653
• Diagnosis 653
• Indications and Contraindications 654
• Bicanalicular-Nasal Stent Placement 655
• Bicanalicular-Annular Stent Placement 655
• Monocanalicular Stent Placement 658
• Mucosal Anastomosis 658
• Stent Materials 658
• Stent Removal 658
• Complications 659
Section 11: Lens
97. Adult Cataracts and Planned Extracapsular Cataract Surgery with
Manual Expression of the Lens Nucleus 663
F Hampton Roy
• Adult Cataracts 663
• Decision-Making Processes 663
• Indications and Contraindications 663
• Surgical Techniques 664
• Phacoemulsification 666
• Technical Alternatives and Pitfalls 668
• Pitfalls 669
• Planned Extracapsular Cataract Surgery with Manual Expression of the Lens Nucleus 672
• Intracapsular Cataract Surgery 674
98. Posterior Capsular Opacification after Cataract Surgery 677
Jerre Minor Freeman
• Management 677
• Indications and Contraindications 678
• Surgical Techniques 678
99. Congenital and Infantile Cataracts 681
F Hampton Roy
• Evaluation of Patient with Lens Abnormalities 681
• Management of Infantile Cataracts 681
• Conservative Management 683
• Indications and Contraindications 683
Contents xxxvii
• Unilateral Lens Abnormalities 683
• Bilateral Lens Abnormalities 684
100. Dislocation of the Lens 693
Devin Gattey, Steven Bailey
• Etiology 693
• Therapy 694
• Indications and Contraindications 694
• Surgical Techniques 695
• Technical Alternatives and Pitfalls 695
101. Dislocation of Intraocular Lenses 697
Michael E Snyder, Mauricio A Perez
• Preoperative Evaluation 697
• Intraocular Lens Explantation 697
102. Foreign Body of the Lens 705
F Hampton Roy
• Indications and Contraindications 705
• Clinical Presentation 705
• Surgical Techniques 705
• Technical Alternatives and Pitfalls 706
• Rehabilitation 706
103. Microincision Cataract Surgery Technique 707
Pawel Klonowski, Jorge L Alió
• Surgical Inquiry 707
• Why Microincision? 707
• Microincision Cataract Surgery Concept 708
• BiMICS Technique 708
• CoMICS Technique 716
• Microincision Cataract Surgery Intraocular Lenses 716
• Microincision Cataract Surgery Results 719
• Microincision Cataract Surgery Expectation 722
104. Fematosecond Laser Cataract Surgery 725
Gregory D Parkhurst, Stephen G Slade
• Inclusion and Exclusion Criteria 725
• Patient Education 726
• Preoperative Examination 727
• Positioning the Patient in the Operating Room 730
• Postoperative Follow-up 732
• Complications 732
xxxviii Master Techniques in Ophthalmic Surgery Section 12: Optic Nerve
105. Optic Nerve Pit Maculopathy 739
Eric Zavaleta, Robert Morris C, Douglas Witherspoon, Ferenc Kuhn, Mathew Sapp
• Preoperative Considerations 741
• Indications and Contraindications 744
• Surgical Techniques 744
• Technical Alternatives and Pitfalls 746
106. Optic Nerve Sheath Hematoma 749
Fang Ko, Uma Sachdeva, Valli Muthappan, Prem Subramanian
• Preoperative Considerations 749
• Indications and Contraindications 750
• Surgical Techniques 751
• Technical Alternatives and Complications 753
107. Papilledema 754
Thomas L Walsh
• Indications and Contraindications 755
• Surgical Techniques 755
108. Giant Cell (Temporal) Arteritis 759
Eric S Ahn, Neil R Miller
• Epidemiology 759
• Indications for and Contraindications to a Temporal Artery Biopsy 761
• Temporal Artery Biopsy 762
Section 13: Orbit
109. Enophthalmos 771
Frank A Nesi, Javier Servat
• Enlargement of the Orbital Space 771
• Poor Orbital Bone Development 773
• Reduction of Orbital Contents 777
110. External Orbital Fracture 780
Richard D Lisman, Gary J Lelli
• Clinical Evaluation—Zygomaticomaxillary Complex Fracture of the Orbit 780
• Classification of Zygomaticomaxillary Complex Fractures 780
• Signs and Symptoms of Zygomaticomaxillary Complex Fractures 782
• Indications and Contraindications 782
• Surgical Techniques 782
Contents xxxix
• Alternative Surgical Procedures and Sites 785
• Rehabilitation 786
• Delayed Complications 787
111. Internal Orbital Fracture 788
Ralph E Wesley, Kimberly A Klippenstein
• Indications and Contraindications 788
• Surgical Techniques 791
• Alternative Techniques and Pitfalls 793
• Rehabilitation 794
112. Preseptal and Orbital Infectious Disease 795
Mira M Sachdeva, Roxana Y Rivera-Michlig
• Clinical Features 795
• Epidemiology 798
• Management 798
• Surgical Techniques 801
• Acute Fulminant Invasive Fungal Sinusitis 802
113. Intraorbital Foreign Body 804
Kasra Eliasieh
• Indications and Contraindications 804
• Surgical Techniques 806
114. Orbital Graves’ Disease 808
J Scott Kortvelesy
• Surgical Therapy 808
• Indications and Contraindications 808
• Technical Alternatives and Pitfalls 813
• Rehabilitation 814
115. Orbital Hemorrhage 817
F Hampton Roy
• Etiology 817
• Classification by Location 818
• Symptoms and Signs 818
• Indications and Contraindications 819
• Surgical Techniques 821
116. Orbital Tumor 825
Devron H Char
• Indications and Contraindications 825
• Surgical Techniques 825
• Fine-Needle Aspiration Biopsy 826
xl Master Techniques in Ophthalmic Surgery • Conventional Orbital Surgery 827
• Lateral Orbitotomy 828
• Superior Orbitotomy 831
117. Pseudotumor Cerebri 835
Brinda Muthusamy, Prem S Subramanian
• Epidemiology 835
• Pathology 835
• Clinical Manifestations 836
• Investigations 836
• Medical Treatment 837
• Surgery 837
• Venous Sinus Stenting 841
Section 14: Refractive Disorders
118. The Surgical Correction of Astigmatism 847
Jonathan B Kahn, Peter A Rapoza, R Bruce Grene, Kenneth R Kenyon
• Types of Astigmatism 847
• Measuring Astigmatism 847
• Nonsurgical Correction of Astigmatism 848
• Surgical Correction of Astigmatism 849
• Surgical Astigmatism: A Stepladder Approach 852
• The Future 852
119. Hyperopia and Myopia 854
Michael J Taravella, Brad Gustave, Jamison Engle
• Surgical Correction of Hyperopia 854
• Patient Work-Up 854
• Special Testing 854
• Historical Methods of Hyperopic Correction 855
• LASIK for Myopia and Hyperopia 863
• PRK versus LASIK 867
• Clear Lens Extraction for Hyperopia 871
120. Myopia (Posterior Segment) 877
F Hampton Roy
• Indications and Contraindications 877
• Posterior Staphyloma 877
• Macular Holes 881
• Posterior Retinal Detachment 881
• Macular Degeneration 885
• Cataract 885
Contents xli
121. Presbyopia 888
Mounir Bashour
• Clinical Thought Process 888
• Indications and Contraindications 889
• Preoperative Evaluation 889
• Immediate Postoperative Care 896
• Rehabilitation 896
• Technical Alternatives and Pitfalls 896
Section 15: Retina
122. Neovascular Age-Related Macular Degeneration 901
Ninel Z Gregori, Philip J Rosenfeld
• Treatment Options 901
• Pitfalls 907
123. Branch Retinal Vein Occlusion 911
Adeel H Shaikh, Robert E Foster
• Pretreatment Considerations 913
• Treatment Indications and Contraindications 915
• Medical Treatment 916
• Laser Treatment 916
• Surgical Treatment 918
124. Central Serous Chorioretinopathy 923
James Landers, Kent Zocchi
• Pathophysiology 923
• Clinical Characteristics 924
• Risk Factors and Associations 924
• Imaging 925
• Treatment 925
• Other Treatments 927
125. Coats’ Disease 930
Eric J Sigler, John C Randolph, Barrett G Haik, Jorge I Calzada
• Clinical Management 932
• Surgical Techniques 933
126. Cystoid Macular Edema 938
Wayne E Fung
• Nonsurgical Approaches to Treating Cystoid Macular Edema 938
• Indications and Contraindications 942
• Surgical Techniques 942
xlii Master Techniques in Ophthalmic Surgery 127. Diabetic Retinopathy 945
Suresh R Chandra, Amol D Kulkarni
• Natural History 945
• Epidemiology 946
• Management 946
• Photocoagulation Technique 948
• Nonclearing Vitreous Hemorrhage 949
• Tractional Retinal Detachment 950
• Anterior-Segment Neovascularization 950
128. Diffuse Unilateral Subacute Neuroretinitis 956
Elizabeth A Verner-Cole, Stephanie K Cramer, Andreas K Lauer
• Indications and Contraindications 956
• Symptomatic Treatment 957
• Surgical Techniques 957
129. Eales Disease 960
David Poon
• Epidemiology 960
• Clinical Features 961
• Treatment 962
130. Giant Retinal Tears 966
F Hampton Roy
• Preoperative Evaluation 966
• Indications and Contraindications 966
• Surgical Techniques 967
• Typical Surgical Procedure 968
• Postoperative Care 969
• Ancillary Techniques 970
• Proliferative Vitreoretinopathy 970
• Heavy Perfluorocarbons 970
• Fellow Eye 971
131. Idiopathic Macular Hole 973
Kent Zocchi
• Findings on Examination 973
• Natural History 974
• Risk of Development of Bilateral Macular Holes 976
• Surgery 976
• Anatomical Closure of the Macular Hole 978
• Indications for Surgery 978
• Results of Surgery 978
Contents xliii
• Internal Limiting Membrane Peeling 979
• Growth Factors 981
• Face Down Positioning 981
• Simultaneous Cataract Surgery and Macular Hole Surgery 981
• Reoperation for Macular Holes 982
• Complications 982
• Retinal Detachment 983
• Paracentral Retinal Holes 983
• Visual Field Defects 983
• The Future 983
132. Macular Pucker 987
F Hampton Roy
• Clinical History and Examination 987
• Clinical Features 987
• Preoperative Evaluation 987
• Indications and Contraindications 988
• Surgical Techniques 988
• Complications 989
• Postoperative Course 989
133. Peripheral Retinal Breaks and Degeneration 991
F Hampton Roy
• Indications and Contraindications 994
• Technical Alternatives 997
• Rehabilitation 997
134. Retinal Tears 1000
Velimir Petrović, William Mabrey
• Surgical Techniques 1002
135. Rhegmatogenous Retinal Detachment 1006
F Hampton Roy
• Indications and Contraindications 1006
• Surgical Techniques 1008
• Special Considerations 1013
• Complications 1014
• Postoperative Care 1015
• Alternative Therapy 1016
136. Retinal Vein Obstruction 1019
George E Sanborn
• Clinical Evaluation 1019
• Indications and Contraindications 1021
xliv Master Techniques in Ophthalmic Surgery • Treatment Techniques 1022
• Clinical Alternatives and Pitfalls 1023
• Rehabilitation 1024
137. Retinoblastoma 1027
F Hampton Roy
• General Considerations 1027
• Enucleation 1027
• Episcleral Plaque Radiotherapy 1030
• Cryotherapy 1031
• Photocoagulation 1032
• Exenteration 1033
• Combined Therapeutic Modalities 1034
• Assessment of Treatment Response 1034
• Follow-Up Procedures 1034
138. Retinopathy of Prematurity 1036
F Hampton Roy
• International Classification of Retinopathy of Prematurity 1036
• Indications and Contraindications 1037
• Surgical Techniques 1038
• Indications and Contraindications 1039
• Surgical Techniques 1040
• Indications and Contraindications 1042
• Surgical Techniques 1042
139. Retinoschisis 1046
Ian Han, David Barañano
• Indications and Contraindications 1047
• Surgical Techniques 1047
• Special Considerations 1049
140. Subretinal Neovascularization 1053
Michael R Pavlica
• Pharmacologic Treatment 1053
• Injection Technique 1054
• Surgical Management 1055
Section 16: Sclera
141. Scleral Laceration 1063
Steve Charles, Eric J Sigler
• Fibrovascular Proliferation 1063
• Endophthalmitis 1063
Contents xlv
• Sympathetic Uveitis 1064
• Presurgical Evaluation 1064
• Indications and Contraindications 1065
• Surgical Techniques 1065
• Scleral Buckling 1066
• Vitrectomy 1066
• Infusion Cannula Placement 1067
• Lensectomy 1067
• Anterior Loop Traction 1067
• Posterior Vitreous Cortex Dissection 1067
• Retinopexy 1067
• Surface Tension Management 1068
142. Anterior Scleral Staphyloma 1069
Ferenc Kuhn, C Douglas Witherspoon, Robert Morris
• Classification 1069
• Preoperative Considerations 1069
• Indications and Contraindications 1070
• Surgical Techniques 1070
• Technical Alternatives and Pitfalls 1072
• Rehabilitation/Long-Term Follow-Up 1073
143. Scleritis 1074
Theresa Gan Leung
• Indications and Contraindications 1075
• Surgical Techniques 1077
• Technical Alternatives and Pitfalls 1077
• Rehabilitation 1078
144. Scleromalacia Perforans 1080
James V Aquavella
• Indications and Contraindications 1080
• Surgical Techniques 1081
• Selection of Anesthesia 1081
• Harvesting of Autologous Periosteum 1081
• Site Preparation 1082
• Application of the Onlay (Patch) Graft 1082
• Alternative Tissues 1083
• Pitfalls and Complications 1084
Section 17: Vitreous
145. Intraocular Foreign Body in the Posterior Segment 1087
Ferenc Kuhn, Robert Morris
• Preoperative Considerations 1087
xlvi Master Techniques in Ophthalmic Surgery
• Indications and Contraindications 1090
• Surgical Technique 1091
• Technical Alternatives and Pitfalls 1093
146. Persistent Hyperplastic Primary Vitreous 1095
James H Antoszyk, Andrew N Antoszyk
• Indications and Contraindications 1096
• Technical Alternatives and Pitfalls 1099
• Rehabilitation 1100
147. Vitreous Hemorrhage 1103
F Hampton Roy
• Indications and Contraindications 1103
• Other Causes of Vitreous Hemorrhage 1104
• Preoperative Evaluation 1104
• Surgical Techniques 1104
• Technical Alternatives and Pitfalls 1107
• Rehabilitation 1107
148. Proliferative Vitreoretinopathy 1109
Steve Charles, Eric J Sigler
• Indications and Contraindications 1110
• Surgical Techniques 1110
• Results 1115
• Complications 1115
149. Vitreous Wick Syndrome 1118
Jessica Chang, Shameema Sikder, Divya Srikumaran
• Indications and Contraindications 1120
• Surgical Techniques 1121
Index 1125