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Ophthalmology is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders.
A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in trouble driving, reading, or recognizing faces. Poor vision caused by cataracts may also result in an increased risk of falling and depression. Cataracts cause 51% of all cases of blindness and 33% of visual impairment worldwide.
The lens, or crystalline lens, is a transparent biconvex structure in most land vertebrate eyes. Along with the cornea, aqueous and vitreous humours it refracts light, focusing it onto the retina. This adjustment of the lens is known as accommodation. In many land animals the lens can accommodate by altering its shape to change the focal length of the eye allowing them to focus on objects at various distances. The accommodation allows a sharp real image of the object of interest to be formed on the retina. In many fully aquatic vertebrates such as fish other methods of accommodation are used such as changing the lens's position relative to the retina rather than changing lens shape. Accommodation is analogous to the focusing of a photographic camera via changing its lenses. In land vertebrates the lens is flatter on its anterior side than on its posterior side while fish the lens is often close to spherical.
Vitrectomy is a surgery to remove some or all of the vitreous humor from the eye.
Eye surgery, also known as ophthalmic or ocular surgery, is surgery performed on the eye or its adnexa, by an ophthalmologist. Eye surgery is synonymous with ophthalmology. The eye is a very fragile organ, and requires extreme care before, during, and after a surgical procedure to minimize or prevent further damage. An expert eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. Today it continues to be a widely practiced type of surgery, with various techniques having been developed for treating eye problems.
Refractive eye surgery is optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism.
Phacoemulsification is a modern cataract surgery method in which the eye's internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber.
Charles David Kelman was an American ophthalmologist, surgeon, inventor, jazz musician, entertainer, and Broadway producer. Known as the father of phacoemulsification, he developed many of the medical devices, instruments, implant lenses and techniques used in cataract surgery. In the early 1960s, he began the use of cryosurgery to remove cataracts and repair retinal detachments. Cryosurgery for cataracts remained in heavy use until 1978, when phacoemulsification, a procedure Kelman also developed in 1967, became the modern standard treatment. Kelman was given the National Medal of Technology by President George H. W. Bush and recognized as the Ophthalmologist of the Century by the International Congress of Cataract and Refractive Surgery in Montreal, Canada. He was also inducted into the National Inventors Hall of Fame in Akron, Ohio, and received the 2004 Lasker Award.
Cataract surgery, also called lens replacement surgery, is the removal of the natural lens of the eye that has developed an opacification, which is referred to as a cataract, and usually its replacement with an artificial intraocular lens.
The lens capsule is a component of the globe of the eye. It is a clear, membrane-like structure composed of collagen IV laminin etc that is quite elastic, a quality that keeps it under constant tension. As a result, the lens naturally tends towards a rounder or more globular configuration, a shape it must assume for the eye to focus at a near distance. The lens capsule is the thickest basement membrane in the body.
Johnson & Johnson Vision (JJV) is a subsidiary of Johnson & Johnson and is composed of two divisions, Johnson & Johnson Surgical Vision and Johnson & Johnson Vision Care. Services include Intraocular lenses, laser vision correction systems, phacoemulsification systems, viscoelastic, Microkeratomes and related products used in cataract and refractive surgery.
Howard V. Gimbel FRCSC, AOE, FACS, CABES, is a Canadian ophthalmologist, university professor, senior editor, and amateur musician. He is better known for his invention, along with Thomas Neuhann, of the continuous curvilinear capsulorhexis (CCC), a technique employed in modern cataract surgery.
Eric John Arnott, MA, FRCS, FRCOphth was a British ophthalmologist and surgeon who specialized in cataracts, a condition which in many parts of the world still remains the principal cause of blindness. He is known for inventing new surgical techniques for treatment of various ophthalmological disorders, and received professional awards for his contributions.
Dr Amar Agarwal M.S., FRCS, F.R.C.Ophth is an Indian ophthalmologist and chairman and managing director of Dr. Agarwal's Eye Hospital and Eye Research Centre in India, which includes 95+ eye hospitals. He is the recipient of the Best Doctor award of the State government from then Chief Minister of Tamil Nadu J Jayalalithaa on 15 August 2014. He is also the past President of the International Society of Refractive Surgery (ISRS) and Secretary General of the Intraocular Implant and Refractive Society of India (IIRSI).
In ophthalmology, glued intraocular lens or glued IOL is a surgical technique for implantation, with the use of biological glue, of a posterior chamber IOL in eyes with deficient or absent posterior capsules. A quick-acting surgical fibrin sealant derived from human blood plasma, with both hemostatic and adhesive properties, is used.
Intraocular lens scaffold or IOL scaffold technique is a surgical procedure in ophthalmology. In cases where the posterior lens capsule is ruptured and the cataract has not yet been removed one can insert the intraocular lens (IOL) inside the eye under the cataract. This way the IOL acts as a scaffold and prevents the cataract pieces from falling inside the back of the eye. The cataract can then be removed safely by emulsifying it with ultrasound and aspiration. This technique is called IOL scaffold and was started by Amar Agarwal from Chennai, India, at Dr. Agarwal's Eye Hospital.
Micro-invasive glaucoma surgery (MIGS) is the latest advance in surgical treatment for glaucoma, which aims to reduce intraocular pressure by either increasing outflow of aqueous humor or reducing its production. MIGS comprises a group of surgical procedures which share common features. MIGS procedures involve a minimally invasive approach, often with small cuts or micro-incisions through the cornea that causes the least amount of trauma to surrounding scleral and conjunctival tissues. The techniques minimize tissue scarring, allowing for the possibility of traditional glaucoma procedures such as trabeculectomy or glaucoma valve implantation to be performed in the future if needed.
The regeneration of the lens of the eye has been studied, mostly in amphibians and rabbits, from the 18th century. In the 21st century, an experimental medical trial has been performed in humans as this is a promising technique for treating cataracts, especially in children.
Hydrodelineation is a method of separating an outer shell of the lens of the eye from the central compact mass of inner nuclear cataract during a cataract surgery by the forceful irrigation of a fluid into the mass of the nucleus. While hydrodissection disconnects the lens from the lens capsule, hydrodelineation splits it into endonuclear and epinuclear sections thus reducing the size of the hard nucleus, making its extraction possible through a smaller incision. This also facilitates phacoemulsification.
Ophthalmic viscosurgical devices (OVDs) are a class of clear gel-like material used in eye surgery to maintain the volume and shape of the anterior chamber of the eye, and protect the intraocular tissues during the procedure. They were originally called viscoelastic substances, or just viscoelastics. Their consistency allows the surgical instruments to move through them, but when there is low shear stress they do not flow, and retain their shape, preventing collapse of the anterior chamber. OVDs are available in several formulations which may be combined or used individually as best suits the procedure, and are introduced into the anterior chamber at the start of the procedure, and removed at the end. Their tendency to remain coherent helps with removal, as the cohesive variants tend to be drawn into the aspiration orifice without breaking up.
References
- ↑ "hydrodissection". medical-dictionary.thefreedictionary.com. Retrieved 20 February 2023.
- ↑ Yanoff, Myron; Duker, Jay S. (1 January 2009). Ophthalmology. Elsevier Health Sciences. ISBN 978-0323043328 – via Google Books.
- ↑ Buratto, Lucio; Apple, David J.; Zanini, Maurizio (25 May 2018). Phacoemulsification: Principles and Techniques. SLACK Incorporated. ISBN 9781556426049 – via Google Books.
- ↑ Issues in Surgical Research, Techniques, and Innovation: 2013 Edition. ScholarlyEditions. 1 May 2013. ISBN 9781490110851 – via Google Books.
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