J. Alio — Minimizing Incisions and Maximizing Outcomes in Cataract Surgery

Автор: J. Alio
Название книги: Minimizing Incisions and Maximizing Outcomes in Cataract Surgery
Формат: PDF
Жанр: Медицина
Качество: Изначально компьютерное, E-book

This book appears at a moment in which cataract surgery is probably making the last
evolution in technology and surgical practice, according to the postulates that Charles
Kelman started in the early 70s. The progressive transition from the initial concept of
small inicision cataract surgery, the development of more and more sophisticated
technology to support the surgeon’s practice of the procedure, the development of
intraocular lenses capable of correcting virtually all types of refractive errors, and the
scientifi c knowledge available today on fl uidics, micromechanics, biomaterials, viscomaterials,
and surgical instrument technology has made cataract surgery experience
one of the greatest progressions and advances of a surgical technique throughout
the history of medicine and surgery.
Cataract surgery at the moment is transforming into a practice in which minimal
agressiveness and optimized outcomes are targeted and tried to achieve by surgeons.
Better diagnostic technology, sophistication in calculation formulas for IOL implantation,
better instruments for incisions, and deeper knowledge into the structure of the
cornea and corneal optics, greater knowledge into issues related intraocular lens performance,
the approach to solve pseudophakic presbyopia by multifocal or accommodative
lenses are, among many others, issues that have been recently advancing
cataract surgery toward its next stage.
Throughout this process, the history of cataract surgery has been related to the
decrease in incision size. This is why an important part of this book is targeting
biaxial microincisional surgery, which seems to be mandatory in the future evolution
of cataract removal. Simplifi cation of the procedure and separation of irrigation and
aspiration seems to be related to better outcomes supported by current scientifi c evidence.
This is possible, thanks to a better knowledge of the instrumentation, fl uidics,
use of ultrasound power, and indeed surgical knowledge and training. The development
of new lenses capable of fi tting through smaller incisions than those currently
available seems to be a limit to the development of the technology. Today, we can
precisely limit our capabilities for cataract removal to 1.6 mm and to 1.8 mm with
IOL implantation. Throughout this book, the reader will be able to learn about the
methods to achieve this benchmark of cataract surgery at this moment.
As we have already mentioned in our opinion, this book appears during the fi nal
stage of the evolution of cataract surgery as conceived today. We anticipate that sub 1
mm surgery will require new technologies, and especially, new IOL technology and
biomaterials. Most probably, we are at the end of the revolution that was started by
Charlie Kelman in the early 70s and in the next decade we shall start a new evolution
toward new issues such as lens replacement through new biomaterials, new accommodating lenses, regenerating surgery, and new technologies to soften the cataract
and to eliminate it through punctures rather than through incisions.
We both, as co-authors, think that the readers will enjoy going through this book
to discover the real cutting edge but practical image offered today by high-quality
cataract surgery practice. We thank all the co-authors of this book, all of them most
relevant professionals and surgical scientists, for their contribution to this book and
to the progress of cataract surgery. Thanks to them and to the support of our families,
this book appears ready to go to your operating room as an advisor for your progression
toward the last transition that cataract surgery will experience with the technology
available today.