Product Description

Looking for quick and user-friendly surgical tips for refractive, cataract, and corneal surgery? Need all of the most important and practical information to be at your fingertips at a moments notice? The updated Second Edition of 101 Pearls in Refractive, Cataract, and Corneal Surgery will rise to the challenge and be your only go-to surgical guide!

Drs. Melki and Azar follow the same format as with their previous edition in that the information is organized as a condensed summary of key pearls and pitfalls of challenging surgical procedures in refractive, cataract, and corneal surgery.

Focusing on practical tips rather than theoretical aspects of surgical procedures, and including clear illustrations of techniques, 101 Pearls in Refractive, Cataract, and Corneal Surgery, Second Edition is a user-friendly, straightforward guide to surgical success. Each pearl will enhance surgical outcomes, reduce surgical time, minimize complications, or simplify a complicated step.

Pearls include practical tips on:

• IOL Calculations after LASIK
• Treatment of post-LASIK keratectasia
• Masking agents for smoother ablation
• Amniotic membrane transplantation
• CK, Monovision, and Blended Vision
• LASIK flap buttonhole prevention and management
• Repairing Descemet’s detachments
• Presbyopic IOLs
• Capsular Dyes in Cataract Surgery

Both beginning and advanced surgeons will benefit from this unique, no-nonsense book of practical tips. Bring 101 Pearls in Refractive, Cataract, and Corneal Surgery, Second Edition into your practice today.

top

Contents

Dedication
Acknowledgments
About the Editors
Contributing Authors
Foreword

Chapter 1: Four Pearls for Surgical Planning With Corneal Topography
Stephen D. Klyce, PhD and Michael J. Endl, MD

1. Keratoconus and Other Suspects
2. Orbscan for a Posterior Perspective
3. So Many Maps, So Little Time
4. Careful Alignment is Not Optional in Refractive Surgery

Chapter 2: Four Pearls in Wavefront Technology
Tohru Sakimoto, MD and Dimitri T. Azar, MD

5. Wavefront Technology and Aberrometry
6. Diagnostic Value of Aberrometry
7. Advantages of Customized Refractive Procedure
8. Limitations of Wavefront-Guided LASIK and LASEK

Chapter 3: Seven Pearls in LASIK Technique With MK and Intralase
Elizabeth A. Davis, MD, FACS; David R. Hardten, MD; and Richard L. Lindstrom, MD

9. Preoperative Counseling and Informed Consent
10. Achieve Adequate Exposure and Achieve and Confirm Adequate Suction
11. Create a Complete Flap and Use Intralase When Appropriate
12. Achieve Consistent Hydration
13. Perform the Appropriate Ablation
14. Reposition the Flap
15. Avoid and Treat Loose Epithelium

Chapter 4: Six Pearls in Prevention and Management of LASIK Complications
Samir A. Melki, MD, PhD and Dimitri T. Azar, MD

16. The Midcut Jam, the Sliding Suction Ring, and the Free Cap
17. Flap Buttonholes
18. The Aborted LASIK and the Repeat LASIK
19. Epithelial Ingrowth: Leave or Lift?
20. Flattening the Recalcitrant LASIK Flap Fold
21. LASIK Flaps: Is Larger Better?

Chapter 5: Four Photorefractive Keratectomy, LASEK, and Epi-LASIK Pearls
Eric Dudenhoefer, MD and Dimitri T. Azar, MD

22. Methods of Epithelial Debridement in Photorefractive Keratectomy
23. LASEK and Epi-LASIK
24. Handling Haze and Decentration in Surface Ablation
25. Photorefractive Keratectomy for Residual Myopia after Radial Keratotomy

Chapter 6: Four Phototherapeutic Keratectomy Pearls
Shahzad Mian, MD and Dimitri T. Azar, MD

26. Location, Location, Location: Depth, Diameter, and Position
27. Best Preoperative Refraction for Better Postoperative Vision
28. Masking Agents for Smoother Ablation
29. Phototherapeutic Keratectomy and the Recurrent Erosion Ladder

Chapter 7: Three Pearls in Excimer Laser Correction and Hyperopia
Nada S. Jabbur, MD; Samir A. Melki, MD, PhD; and Dimitri T. Azar, MD

30. Latent Hyperopia, Spasm of Accommodation, and Undercorrected Astigmatism
31. Hyperopic LASIK: The Importance of Eye Tracking
32. Hyperopic Photorefractive Keratectomy: The Epithelial Challenge

Chapter 8: Two Irregular Astigmatism Pearls
Ramon C. Ghanem, MD; Faisal Al-Tobaigy, MD; Elena Albè, MD; and Dimitri T. Azar, MD

33. Secondary Hyperopia and Irregular Astigmatism After Radial Keratotomy and Decentered Ablation
34. Treatment of Keratectasia in Keratoconus Following LASIK

Chapter 9: Four Pearls on Presbyopic Correction
Elena Albé, MD; Faisal Al-Tobaigy, MD; Ramon C. Ghanem, MD; Samir A. Melki, MD, PhD; and Dimitri T. Azar, MD

35. Monovision Refractive Surgery
36. Conductive Keratoplasty, Monovision, and Blended Vision
37. Scleral Surgery for Presbyopia
38. Accommodating and Multifocal Intraocular Lenses

Chapter 10: Seven Pearls in Phakic Intraocular Lens Implantation
Thanh Hoang-Xuan, MD; Jean-Louis Arné, MD; and Georges Baikoff, MD

39. Phakic Intraocular Lenses: What Size?
40. Iris Visco-Stretch Prevents Mydriasis and Iris Prolapse
41. Verisyse Lens: Iris Enclavation
42. Implantable Contact Lens: Prevent Pigment Dispersion
43. The Inverted Implantable Contact Lens
44. Removal of the Viscoelastic Agent
45. Bioptics

Chapter 11: Three Pearls for Successful Cataract Surgery Using Topical Anesthesia
H. John Shammas, MD and Rania M. Shammas, MD

46. Anesthesia without Akinesia: What If the Eye Moves?
47. Enhancing Topical Anesthesia with Adjunctive Measures
48. The Unsuitable Candidate for Topical Anesthesia

Chapter 12: Four Pearls to Conquer the Difficult Iris
Pierre G. Mardelli, MD and Samir A. Melki, MD, PhD

49. Small Pupil, Big Challenge
50. The Hidden Capsulorrhexis
51. The Floppy Iris Syndrome
52. Tips for Iris Sutures

Chapter 13: Two Pearls in Phacofluidics and Bimanual Phacoemulsification
Tais Hitomi Wakamatsu, MD and Dimitri T. Azar, MD

53. Phacoemulsification Fluidics
54. Bimanual Phacoemulsification

Chapter 14: Three Pearls in Avoiding Phacoemulsification Corneal Burns
James J. Reidy, MD, FACS

55. Proper Hand Positioning
56. Appropriate Irrigation Flow
57. Debulk the Viscoelastic in the Anterior Chamber and Minimize the Use of Ultrasound Power

Chapter 15: Five Pearls in the Management of Crystalline and Artificial Intraocular Lens Dislocation
Ammar N. Safar, MD; Natalie A. Afshari, MD; and Alexandre Assi, Bsc, MBBS, FRCOphth

58. Posterior-Assisted Levitation
59. The Sheath Glide Maneuver
60. McCannel Sutures for Dislocated Intraocular Lenses
61. Double-Knot Transscleral Suture Fixation Technique for Sunset and Sunrise Syndromes
62. Double-Knot Technique for Iris Fixation of Decentered, Dislocated, or Subluxated Silicone Plate Haptic Intraocular Lenses

Chapter 16: Eight Pearls for Challenging Cases in Cataract Extraction
Richard Mackool, MD

63. Capsular Dyes
64. The Runaway Rhexis
65. Pseudoexfoliation Quandary
66. The Shallow Anterior Chamber
67. Infusion Misdirection Syndrome
68. Techniques for Reattachment of Descemet's Membrane
69. Upright Phacoemulsification
70. Intraocular Lens Power Calculation after LASIK

Chapter 17: Five Pearls in Limbal Stem Cell Transplantation
Kimberly C. Sippel, MD and C. Stephen Foster, MD, FACS

71. Correctly Identify Limbal Stem Cell Deficiency
72. Optimize the Ocular Surface
73. Limbal Stem Cell Autografting: Make Sure the Contralateral Eye is Normal
74. Limbal Stem Cell Allografting: Human Leukocyte Antigen Typing and Postsurgical Immunosuppression
75. Combining Limbal Stem Cell Transplantation and Corneal Grafting: At the Same Time or Spaced Apart?

Chapter 18: Two Pearls for Successful Pterygium Excision
Tushar Agarwal, MD; Namrata Sharma, MD; and Rasik B.Vajpayee, MS, FRCSEd

76. Mitomycin C: Pros and Cons
77. Cosmetic Autografts with Fibrin Tissue Glue

Chapter 19: Three Pearls in Amniotic Membrane Transplantation
Kimberly C. Sippel, MD and C. Stephen Foster, MD, FACS

78. Amniotic Membrane Transplantation: When Would One Consider Using It?
79. Amniotic Membrane Transplantation: Where Does One Obtain Amniotic Membrane?
80. Inlay or Overlay?

Chapter 20: Three Pearls for Suturing Corneal Incisions and Lacerations
Roberto Pineda II, MD

81. Head On or Shelve It
82. The Compression Factor and Wound Override
83. The Sutureless Repair of Corneal Lacerations

Chapter 21: Three Pearls in Successful Application of Cyanoacrylate Glue to the Cornea
Jonathan D. Primack, MD

84. Indications: To Glue or Not to Glue?
85. Gluing Tips and Avoiding Sticky Situations
86. Maintenance of Glue on the Ocular Surface

Chapter 22: Six Pearls in Challenging Corneal Surgery
Esen K. Akpek, MD; Rana Altan-Yaycioglu, MD; and Walter J. Stark, MD

87. The Neurotrophic Cornea
88. The Vascularized Cornea
89. Enhancing Regrafting Success
90. Epithelial Downgrowth
91. Contralateral Corneas in Monocular Patients (Autokeratoplasty)
92. Lamellar Keratoplasty

Chapter 23: Three Pearls to Minimize Postkeratoplasty Astigmatism
Tushar Agarwal, MD; Namrata Sharma, MD; Rasik B.Vajpayee, MS, FRCSEd; and Samir A. Melki, MD, PhD

93. Better Choices in Graft Size
94. Avoid Oval Trephination
95. Running Versus Interrupted Sutures

Chapter 24: Three Pearls in Managing Posterior Vitreous Pressure During Penetrating Keratoplasty
Sadeer B. Hannush, MD

96. Avoid Posterior Vitreous Pressure: Using Physics to Your Advantage
97. Closed Chamber or Open-Sky Phaco-Assisted Cataract Extraction
98. Vitrectomy in Keratoplasty

Chapter 25: Three Pearls in Posterior Keratoplasty
Tae-Young Chung, MD and Dimitri T. Azar, MD

99. Femtosecond Laser-Assisted Small Incision Deep Lamellar Endothelial Keratoplasty
100. Descemet’s Stripping and Transplantation of Endothelium (Melles and Price Techniques)
101. Microkeratome-Assisted Posterior Keratoplasty

Index

top

Reviews

"This is the second edition of a manual that proved highly successful the first time round, and represents an update on various aspects of anterior segment ocular surgery…The format is excellent…The book is written in a down-to earth style, which is very easy to read. One can certainly read the book systematically, but I found that opening up at a random page to 'dip in' equally rewarding…I highly recommend it to practicing surgical ophthalmologists of all grades…I would imagine the success of this format will encourage future editions in the years to come."

— Dr. Norman Litvin, UNIVADIS

"Melki and Azar have assembled an international cast of contributors to produce this concise, clear, practical volume, which is aimed at practitioners and assumes a certain degree of familiarity with surgical technique, indication and practice. . . . It is attractively presented, with good clear fonts on high-quality paper, and a range of full-colour photographs and diagrams. The book I reviewed was a soft-cover with an attractively colourful cover. It is a snappy cover that reflects the snappy concept contained therein. . . Overall, I was impressed with this book, which will complement comprehensive textbooks for the trainee ophthalmologist of the anterior section, with access to the technical innovations mentioned."

— Seamus Sweeney, MD, EuroTimes

"One can find a treasure trove of valuable pearls in the complex area of laser refractive surgery, including a discussion of complication management. In my opinion, this is the most concise review of problems encountered in this area currently available in print, short of fellowship training (or retraining). . . .I recommend this book to anyone who considers himself or herself an anterior segment surgeon. I dare you not to learn at least a few tricks within these pages, regardless of your experience."

— Mitchell Vogel, MD, FACS, Ocular Surgery News

top

About the Editors

Samir Melki, MD, PhD

Dr. Melki is the Founder and Director of the Boston Eye Group. He is medical director for ophthalmology at the UK Specialist Hospitals. He is also a clinical instructor at Harvard Medical School and assistant in Ophthalmology at the Massachusetts Eye and Ear Infirmary. Dr Melki completed his ophthalmology residency at Georgetown University Hospital, where he was elected as Chief Resident. This was followed by a fellowship in Corneal and Refractive Surgery at the Massachusetts Eye and Ear Infirmary, where he served as Chief Fellow. His areas of interest include refractive surgery, complex cataract surgery, and ocular surface reconstruction.

Dimitri Azar, MD

Dr. Azar is Professor and Chairman of Ophthalmology at the University of Illinois at Chicago (UIC). After completing his residency, chief residency, and fellowship at the Massachusetts Eye and Ear Infirmary, Dr. Azar became Director of the Refractive Surgery Service at the Wilmer Eye Institute (Johns Hopkins University; 1991-1996). While at the Massachusetts Eye and Ear Infirmary, he was Director of the Corneal and Refractive Surgery Services and Associate Chief of Ophthalmology (1996-2003) and became Professor of Ophthalmology at Harvard Medical School (2003-2006). His research interests include refractive surgery, corneal wound healing, and corneal angiogenesis.

top