Ophthalmology Clinics of North America RSS feed: Current Issue. http://www.ophthalmology.theclinics.com/?rss=yesElsevier Inc.en © 2006 Published by Elsevier Inc. All rights reserved. Ophthalmology Clinics of North America0896-1549194December 2006 © 2006 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.ophthalmology.theclinics.com/article/PIIS0896154906000861/abstract?rss=yesTable of Contents10.1016/S0896-1549(06)00086-1Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4vviihttp://www.ophthalmology.theclinics.com/article/PIIS0896154906000873/abstract?rss=yesForthcoming Issues10.1016/S0896-1549(06)00087-3Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4viiiviiihttp://www.ophthalmology.theclinics.com/article/PIIS0896154906000654/abstract?rss=yesWe live in times when ideas, research, and experience are shared almost instantly, mostly to the benefit of our patients. And in few areas more than in cataract surgery, does the state of the art change more rapidly. It can then be difficult to decide when a compendium of the current knowledge base should be committed to hard copy, and probably great hubris to commit it to hard cover.PrefaceMark H. Blecher10.1016/j.ohc.2006.07.010Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4ixixhttp://www.ophthalmology.theclinics.com/article/PIIS0896154906000630/abstract?rss=yesCataract poses a substantial economic and public health burden and is the leading cause of blindness worldwide, accounting for nearly 48% of all blindness . As such it is also a disease that has been and will continue to be a target of epidemiologic research. Insights into causative factors amenable to intervention, genetic factors that predispose to disease, and avenues for novel treatment serve to reduce the disease burden.The New Epidemiology of CataractAlison G. Abraham, Nathan G. Condon, Emily West Gower10.1016/j.ohc.2006.07.008Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4415425http://www.ophthalmology.theclinics.com/article/PIIS0896154906000587/abstract?rss=yesDiabetes mellitus has become one of the fastest growing health epidemics in the world. According to data analyzed from the 2002 National Health Interview Survey, it is estimated that 18.2 million Americans are afflicted with this disease, with over 1.3 million new cases diagnosed each year in people over the age of 20. Of those with the disease, approximately 5.2 million are undiagnosed or underdiagnosed . With the aging of the United States population, the number of older persons with diabetes is likely to increase, with an estimated number of diagnosed persons to reach 29 million by 2050 .Perioperative and Operative Considerations in DiabeticsDavid R. Fintak, Allen C. Ho10.1016/j.ohc.2006.07.003Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4427434http://www.ophthalmology.theclinics.com/article/PIIS0896154906000642/abstract?rss=yesWith increased safety of the procedure itself, cataract surgery now is being performed in patients who have less visual disability than several years ago. Today's cataract surgery occurs at an earlier age, and with implants for monofocal and multifocal corrections, patients now anticipate excellent uncorrected acuity, not just improved best corrected vision. Because patients have come to view cataract surgery as both a rehabilitative and refractive procedure, surgeons, for better or for worse, now are being judged mainly for their refractive outcomes. This expectation places increased importance on accurate biometry and intraocular lens (IOL) calculations, the topics covered in this article. Accuracy of the measurements has a consequence in patient satisfaction and depends on correct determination of eye length, IOL position, refractive power of the cornea, and selection of the proper IOL formula. Familiarity with these variables will make it easier to achieve precise results in both the intact eye and in eyes that have had previous surgeries, including keratorefractive procedures.Enhancing Intraocular Lens Outcome Precision: An Evaluation of Axial Length Determinations, Keratometry, and IOL FormulasThomas C. Prager, David R. Hardten, Benjamin J. Fogal10.1016/j.ohc.2006.07.009Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4435448http://www.ophthalmology.theclinics.com/article/PIIS0896154906000605/abstract?rss=yesEndophthalmitis is a rare but devastating complication of intraocular surgery that often carries a poor prognosis. This article examines the rising incidence of endophthalmitis and reviews perioperative techniques used to reduce the rate of endophthalmitis.Endophthalmitis ProphylaxisJudy I. Ou, Christopher N. Ta10.1016/j.ohc.2006.07.005Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4449456http://www.ophthalmology.theclinics.com/article/PIIS0896154906000800/abstract?rss=yesThe most common surgical procedure in the United States is cataract surgery ; more specifically, phacoemulsification. Understanding the fluidics and ultrasonic power fundamentals for phacoemulsification machines is instrumental for their safe and efficient use. Although phaco machines have evolved considerably since they were introduced a few decades ago, the basic concepts have remained the same.Phaco Fluidics and Phaco Ultrasound Power ModulationsUday Devgan10.1016/j.ohc.2006.08.001Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4457468http://www.ophthalmology.theclinics.com/article/PIIS0896154906000629/abstract?rss=yesModern cataract surgery is now in the realm of refractive surgery and patients expect almost perfect results. The development and manufacture of intraocular lenses (IOLs) is evolving rapidly. The most energy and funding is probably being spent on the development of new and complex IOLs that not only restore the refractive power of the eye after cataract surgery, but also provide special features, including multifocality, toric corrections, pseudoaccommodation, and so forth . This article describes some of the new technology regarding materials and designs currently available or under development for the manufacture of modern IOLs.New Technology IOL OpticsLiliana Werner, Randall J. Olson, Nick Mamalis10.1016/j.ohc.2006.07.007Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4469483http://www.ophthalmology.theclinics.com/article/PIIS0896154906000599/abstract?rss=yesOver the past several years the concept of refractive cataract surgery has received increased attention from surgeons, and the need for its adoption has recently been made more urgent by the approval and availability of new presbyopia-correcting intraocular lenses (IOL). Indeed, the need to manage pre-existing astigmatism has become a requisite aspect of modern phacosurgery. Experience with keratorefractive surgery has proved that astigmatism of as little as 0.75 diopters (D) may leave a patient symptomatic with visual blur, ghosting, and halos. To embrace this notion of refractive cataract surgery fully, the dedicated surgeon must aspire to a level of accuracy that equates with corneal-based refractive surgery. Fortunately, techniques have emerged that afford the refractive lens surgeon the ability to effectively, safely, and reproducibly reduce cylinder error to acceptable levels of 0.50 D or less, either at the time of cataract surgery, or through a subsequent enhancement procedure.Astigmatism ControlLouis D. Nichamin10.1016/j.ohc.2006.07.004Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4485493http://www.ophthalmology.theclinics.com/article/PIIS0896154906000575/abstract?rss=yesVitreous loss is inevitable. Given the variety of pathology presented by the human eye, even the best surgeons have some complications. Despite the application of vigilant maneuvers, broken capsules still occur at a rate between 0.45% for very experienced surgeons and up to 14.7% for residents in training . The frequency of retained lens fragments is estimated at 0.3% to 1.1% . The challenge of cataract surgery is to minimize the risk of complications and to manage optimally complications that do occur.Management of Vitreous Loss and Dropped Nucleus During Cataract SurgeryLisa Brothers Arbisser, Steve Charles, Michael Howcroft, Liliana Werner10.1016/j.ohc.2006.07.002Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4495506http://www.ophthalmology.theclinics.com/article/PIIS0896154906000563/abstract?rss=yesSmall-incision phacoemulsification with endocapsular posterior chamber intraocular lens (PCIOL) fixation has become the standard of care in cataract management because of numerous intraoperative and postoperative advantages. When associated with zonular weakness, cataract surgery is associated with increased risk of vitreous prolapse, capsular rupture, retained lens material, and postoperative IOL dislocation. In cases of profound zonular dialysis, alternative approaches have included intracapsular cataract extraction or pars plana vitrectomy and lensectomy. The capsular tension ring (CTR) and its derivatives have enabled surgeons to approach zonular weakness with improved safety, and spawned novel surgical techniques. Successful phacoemulsification approaches in these cases requires stabilization of the capsulozonular apparatus during surgery, enabling the surgeon safely to remove the crystalline lens, retain the capsular bag, and place a PCIOL securely. This requires an understanding of capsule and zonular anatomy, development of a grading system for zonular weakness, technique modifications, and an understanding of available capsular tension devices and their selection criteria.Capsular Tension Rings: Update on Endocapsular Support DevicesKhalid Hasanee, Iqbal Ike K. Ahmed10.1016/j.ohc.2006.07.001Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4507519http://www.ophthalmology.theclinics.com/article/PIIS0896154906000617/abstract?rss=yesFunctional vision means the ability of the visual system to receive, transmit, and report information. The optical system of the eye allows reception, whereas the neurosensory retina and the neural pathways to the visual cortex govern transmission. Cortical elements in turn report information.Contrast Sensitivity and Measuring Cataract OutcomesMark Packer, I. Howard Fine, Richard S. Hoffman10.1016/j.ohc.2006.07.006Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4521533http://www.ophthalmology.theclinics.com/article/PIIS0896154906000915/abstract?rss=yesIndex10.1016/S0896-1549(06)00091-5Ophthalmology Clinics of North America 19, 4 (2006)2006-12-01Ophthalmology Clinics of North America2006-12-01194S0896-1549(06)X0021-4535538