Sei sulla pagina 1di 7

See

discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/233939117

Intraocular pressure variation during


femtosecond laser-assisted cataract surgery
using a fluid-filled interface

Article in Journal of Cataract and Refractive Surgery · January 2013


DOI: 10.1016/j.jcrs.2012.10.038 · Source: PubMed

CITATIONS READS

45 83

4 authors, including:

Tim Schultz Fritz H Hengerer


Ruhr-Universität Bochum University Hospital Frankfurt
63 PUBLICATIONS 842 CITATIONS 54 PUBLICATIONS 755 CITATIONS

SEE PROFILE SEE PROFILE

H. Burkhard Dick
Ruhr-Universität Bochum
523 PUBLICATIONS 5,686 CITATIONS

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

future Direction View project

Opportunities & Challenges in the field of Biomaterials & Medical devices View project

All content following this page was uploaded by H. Burkhard Dick on 25 February 2016.

The user has requested enhancement of the downloaded file.


ARTICLE

Intraocular pressure variation during


femtosecond laser–assisted cataract surgery
using a fluid-filled interface
Tim Schultz, MD, Ina Conrad-Hengerer, MD, Fritz H. Hengerer, MD, H. Burkhard Dick, MD

PURPOSE: To evaluate intraocular pressure (IOP) during femtosecond laser–assisted cataract sur-
gery using a fluid-filled interface.
SETTING: Ruhr University Eye Clinic, Bochum, Germany.
DESIGN: Prospective clinical trial.
METHODS: The absolute IOP was measured with a modified Schiotz tonometer before and after
laser-assisted cataract surgery with and without a fluid-filled interface (Liquid Optics interface,
Catalys Precision Laser System).
RESULTS: The study evaluated 100 eyes. Tonometry and laser cataract surgery were completed
successfully in all eyes. The mean preoperative IOP was 15.6 mm Hg G 2.5 (SD). Upon application
of the suction ring and vacuum, the mean IOP rose to 25.9 G 5.0 mm Hg and remained nearly con-
stant after the laser procedure (27.6 G 5.5 mm Hg). After removal of the suction ring, the mean IOP
was 19.1 G 4.4 mm Hg. The IOP 1 hour after surgery was not significantly higher than the pre-
operative values.
CONCLUSIONS: The results indicate a minor increase in IOP using the fluid-filled interface. This is in
strong contrast to substantially higher values reported in the literature with flat and curved
applanating contact interfaces.
Financial Disclosure: Dr. Dick is a member of the Medical Advisory Board and a paid consultant to
Optimedica, Sunnyvale, California, USA. No other author has a financial or proprietary interest in any
material or method mentioned.
J Cataract Refract Surg 2013; 39:22–27 Q 2013 ASCRS and ESCRS

Manual capsulorhexis and ultrasound phacoemulsifi- Like laser in situ keratomileusis (LASIK) ablation la-
cation are the current treatment standard for cataract ser systems, all ophthalmic femtosecond laser systems
surgery.1,2 The introduction of femtosecond lasers for use a patient interface to directly contact the patient’s
cataract surgery shows great promise in increasing eye to maintain mechanical stability between the opti-
the accuracy and precision of the cuts compared cal laser system and the patient and to allow a well-
with manual treatment.3 With this tool, future clinical defined optical interface. In addition, the interfaces
studies should show improved patient safety profiles are used to register the ocular target and the laser focal
and refractive outcomes.3–8 position to ensure that the incision is in the correct
location.
Submitted: June 3, 2012.
A flat applanating contact lens was introduced with
Final revision submitted: October 5, 2012. the first femtosecond laser (Intralase, Abbott Medical
Accepted: October 11, 2012. Optics, Inc.) for flap creation. This interface proved
to be reliable and is still in use today despite very
From the Center for Vision Science, Ruhr University Eye Clinic, high intraocular pressure (IOP) resulting from corneal
Bochum, Germany. compression during the applanation process. Various
Corresponding author: Tim Schultz, MD, Center of Vision Science, studies9–11 have evaluated IOP changes in in vivo or
Ruhr University Eye Hospital, In der Schornau 23-25, 44892 ex vivo animal models. The reported mean maximum
Bochum, Germany. E-mail: tim.schultz@kk-bochum.de. IOP in enucleated porcine globes during the regular

22 Q 2013 ASCRS and ESCRS 0886-3350/$ - see front matter


Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jcrs.2012.10.038
IOP DURING LASER-ASSISTED CATARACT SURGERY USING A FLUID-FILLED INTERFACE 23

procedure was 134 mm Hg G 16 (SD) when the Intra- hard-curved patient interfaces.A Because previously
lase device was used and 184 G 28 mm Hg when the applanation tonometry was not possible during fem-
Femto LDV device (Ziemer Ophthalmic Systems AG) tosecond laser surgery, studies9–12 used direct cannu-
was used.11 lation of the anterior chamber or vitreous body to
To reduce these IOP peaks, other femtosecond flap measure the IOP. The fluid-filled interface provides ac-
laser systems use a curved applanation interface in cess to the cornea and offers the possibility of atrau-
which the interface has some amount of curvature to matic examinations.
better fit the natural corneal curvature; this limits the It has been reported that Schiotz tonometers mea-
IOP rise during applanation. Reported mean maxi- sure different IOP than Goldmann-type tonometers,
mum IOPs during the regular procedure using the with the results reported as higher and as lower.24–26
curved applanation interface with porcine globes As such, a range of Schiotz-measured pressures is
were between 65 G 20 mm Hg (Visumax, Carl Zeiss generally reported rather than a single value. We ac-
Meditec AG) and 205 G 32 mm Hg (Femtec, Technolas knowledge this but chose to use the Schiotz tonometer
Perfect Vision GmbH).11 Similar data were shown in because it readily fits within the small inner volume of
the few available in vivo human studies.12 the interface and is oriented for use with supine
With laser-assisted cataract surgery, significantly patients. The preoperative measurements using both
older patients are exposed to IOP increases for several Goldmann and Schiotz tonometers agreed well.
minutes during treatment. These individuals are at The aim of this prospective clinical trial was to quan-
higher risk for complications than relatively young tify the absolute IOP variation during femtosecond la-
and healthy refractive LASIK surgery patients. In the ser–assisted cataract surgery using the Catalys Liquid
United States, up to 39% of the people older than Optics Interface.
65 years are under permanent anticoagulation with
aspirin and optic nerve perfusion is lower.13,14 PATIENTS AND METHODS
Furthermore, the incidence of chronic open-angle This study comprised patients scheduled for elective femto-
glaucoma and ocular hypertension, as well as retinal second laser–assisted cataract surgery and implantation of
occlusive disease, increases with age.15,16 It has been an intraocular lens (IOL) by 1 of 2 trained surgeons
reported that the use of traditional laser system (H.B.D., F.H.) at the Center for Vision Science, Ruhr Univer-
sity Eye Clinic, Bochum, Germany. The study received insti-
patient interfaces may increase the risk for subconjunc-
tutional review board approval of the Ethics Committee,
tival hemorrhage,17 retinal detachment,18 optic neuro- Ruhr University, and all aspects of the Declaration of Helsin-
pathy,19 macular holes,20 and foveal hemorrhage.21 ki were observed.
For some time, ultrasonic examination devices have Patients were eligible for the study if they had significant
used water immersion to minimize the impedance cataract, were older than 21 years, and understood and
signed an informed consent document. Excluded were pa-
mismatch between the transducer and the eye.22
tients with mature cataracts, angle-closure or uncontrolled
With this technique, no pressure is applied to the cor- glaucoma, active inflammation in the eye, a history of cor-
nea because there is no direct force or deformation of neal surgery, opacities or corneal disease, central corneal
the corneal structure. Only the sealing interface is in thickness less than 500 mm or greater than 600 mm, active
direct contact with the sclera. iris neovascularization, presence of intraocular silicone oil,
ocular or systemic steroid use within 3 months before the
Currently available femtosecond laser cataract sur-
preoperative visit, participation in another drug or device
gery systems use a curved applanation patient inter- clinical trial concluding within 30 days of the preoperative
face (Lensx Laser System, Lensx; Victus, Technolas visit, unsuitable for local anesthesia, known or suspected al-
Perfect Vision GmbH) or a fluid-filled interface lergy to drugs required for the protocol, or who were preg-
(Catalys Precision Laser, Optimedica; Lensar Laser nant or nursing.
System, Lensar, Inc.).23 Similar to the ultrasonic im-
mersion interfaces, the fluid-filled interfaces for the Laser System and Patient Interface Docking
laser systems overcome the optical refraction of the All laser surgery was performed with the Catalys Preci-
cornea while avoiding the corneal deformation and sion Laser System, which has been described in detail.27
associated IOP rise. Such a configuration should After patient docking, the system automatically detects the
cornea and lens surfaces using optical coherence tomogra-
substantially limit the IOP increase, as is appropriate phy (OCT) and creates a 3-dimensional (3-D) treatment
for the cataract surgery patient population. The only plan for each patient.
possible cause of an IOP rise might be induced by The Catalys patient interface is composed of 2 parts: a suc-
the water-sealing interface or suction ring that is ap- tion ring that contacts only the sclera (outer diameter
plied to the eye. Proper design of this suction ring 18.0 mm) and a disposable lens that rigidly mates the suction
ring to the surgical system. In the first step, the suction ring
should greatly minimize, if not avoid, the IOP rise. (Figure 1, B) is placed centrally on the sclera of the eye
In addition, the fluid-filled interface avoids the folds (Figure 1, A). After fine adjustments, the suction ring vac-
in the corneal posterior surface associated with uum is enabled, which connects the suction ring to the

J CATARACT REFRACT SURG - VOL 39, JANUARY 2013


24 IOP DURING LASER-ASSISTED CATARACT SURGERY USING A FLUID-FILLED INTERFACE

Table 1. Study time points and IOP measurement device used.

Study Time Point Device Used

Preoperative Goldmann tonometer


Before suction Schiotz tonometer
With suction Schiotz tonometer
After femto with suction Schiotz tonometer
After femto without suction Schiotz tonometer
1 hour postoperative Goldmann tonometer

1 hour postoperative Z IOP measured 1 hour after surgery on sitting pa-


tients; After femto with suction Z IOP measured after laser procedure
with suction ring in place and with applied vacuum on lying patients; Af-
ter femto without suction Z IOP measured 1 minute after vacuum turned
off and suction ring removed on lying patients; Before suction Z IOP
measured before laser treatment on lying patients; Preoperative Z IOP
measured 2 days before surgery on sitting patients; With suction Z IOP
measured after applying vacuum to suction ring on lying patients

Surgical Technique
Femtosecond laser–assisted cataract surgery was per-
formed in 1 eye of each patient. After pupil dilation (phenyl-
ephrine 2.5% and tropicamide 0.5%) and corneal anesthesia
(oxybuprocaine hydrochloride, Conjucain EDO 0.4%,
Bausch & Lomb), all patients were placed in a supine posi-
tion in the operating chair. No eye speculum was used. After
the patient was docked to the system, the OCT imaged the
anterior chamber and the system created a 3-D treatment
plan. In all cases, the laser created a 5.0 mm diameter curvi-
linear capsulotomy (4 mJ pulse energy). The lens was seg-
mented into quadrants and softened with grid spacing of
350 mm (10 mJ pulse energy).
All patient’s remained in the same operating chair during
Figure 1. Schematic of the docking process (A Z eye; B Z suction the entire procedure. The manual surgical cataract procedure
ring; C Z disposable lens; 1 Z docking between suction ring and was performed directly after laser treatment and measure-
eye; 2 Z docking between disposable lens and suction ring). ments. The Stellaris phacoemulsification device (Bausch &
Lomb) was used for nuclear disassembly.
patient’s eye. Second, the suction ring volume is filled with
a balanced salt solution (BSS, Alcon). In the final step, the Statistical Analysis
filled suction ring is adjusted and connected to the dispos-
able lens (Figure 1, C). Excess fluid is free to discharge Intraocular pressure values, patient age, and total suction
from any of 3 openings near the top of the suction-ring time were calculated using the mean G SD. The significance
housing. of IOP changes was calculated using the t test. A P value less
than 0.05 was considered statistically significant. All calcula-
tions were performed using SPSS Statistics for Windows
Intraocular Pressure Measurements software (version 19.0, SPSS, Inc.).
Pretreatment and posttreatment IOPs were measured us-
ing a Goldmann tonometer. The results were adjusted to the
RESULTS
corneal thickness with the Dresdner chart.28 All other read-
ings were performed using a modified Schiotz tonometer. The study group consisted of 51 men and 49 women
The handles of a Schiotz tonometer were bent upward to en- with a mean age of 70 G 12 years (range 28 and 91
able pressure readings even with the suction ring applied to years).
the patient’s eye. Before every application, the Schiotz to-
nometer was cleaned by submersion in sodium hypochlorite Table 2 and Figure 2 show the mean measured IOPs.
2% solution and the calibration was checked with the manu- No significant difference was found between baseline
facturer’s calibration sphere. For all measurements, the 7.5 g IOP 2 days before treatment and the IOP right before
weight was used.29 The laser procedure and pressure read- suction ring application (PZ1.0). After the vacuum
ings were performed by the same surgeon (H.B.D. or F.H.). was applied to engage the suction ring to the patient’s
Pressure readings were taken as shown in Table 1. Directly
after surgery, patients were asked whether they had vision eye, the IOP significantly increased by a mean of
problems during the procedure; for example, whether amau- 10.3 mm Hg (P!.001). Laser-assisted cataract treat-
rosis occurred. ments were successfully performed in all cases. No

J CATARACT REFRACT SURG - VOL 39, JANUARY 2013


IOP DURING LASER-ASSISTED CATARACT SURGERY USING A FLUID-FILLED INTERFACE 25

levels 1 hour after surgery, but not higher than the pre-
Table 2. Mean IOP data at the different study time points and
their statistical significance. treatment level (PZ.038).

Mean (mm
Study Time Point Hg) G SD Range P Value DISCUSSION
Preoperative 15.6 G 3.4 8.0, 23.0 1.000 The measurements showed an increase in IOP result-
Before suction 15.6 G 2.5 9.0, 21.9 !.001 ing from the use of the suction ring. A second rise in
With suction 25.9 G 5.0 17.0, 38.8 !.001 IOP was induced by the femtosecond laser treatment.
After femto with suction 27.7 G 5.5 15.6, 38.8 !.001 In all cases, the highest recorded pressure did not ex-
After femto without suction 19.1 G 4.4 9.0, 30.4 !.001 ceed 38.8 mm Hg and the IOP returned to a normal
1 hour postoperative 14.3 G 4.4 8.0, 26.0 level after the suction ring was removed.
1 hour postoperative Z IOP measured 1 hour after surgery on sitting pa- To our knowledge, no other study has analyzed the
tients; After femto with suction Z IOP measured after laser procedure IOP variations in vivo during femtosecond laser–assis-
with suction ring in place and with applied vacuum on lying patients; Af- ted cataract surgery with a fluid-filled interface. The
ter femto without suction Z IOP measured 1 minute after vacuum turned
off and suction ring removed on lying patients; Before suction Z IOP only available data are results that assessed the
measured before laser treatment on lying patients; Preoperative Z IOP changes in IOP in porcine and human cadaver eyes af-
measured 2 days before surgery on sitting patients; With suction Z IOP ter suction. These findings indicated a mean increase
measured after applying vacuum to suction ring on lying patients
in IOP in porcine eyes of 17.7 G 2.1 mm Hg and of
3.8 mm Hg lower in human cadaver eyes.B
No additional IOP increase is expected from the
patients had suction loss during the laser treatment,
weight or pressure of the balanced salt solution added
and no adverse events occurred. Furthermore, no pa-
to the suction ring because excessive balanced salt solu-
tient reported amaurosis. Immediately after laser
tion can vent through the opening in the suction ring
treatment, with suction ring still applied, the IOP
when it is displaced by the lens during docking. Never-
increased significantly (P!.001). After removal of
theless, lateral force during the docking process might
the suction ring, the IOP decreased significantly. The
induce an additional IOP rise that was not measured.
mean total suction time was 3:45 G 1:21 minutes.
In all patients, the IOP will rise during the docking
Standard cataract surgery and IOL implantation was
process when the suction ring mates with the dispos-
performed in all cases. The IOP was back to initial
able lens. Because the cornea is fully enclosed by the la-
ser system, no pressure reading could be taken at this
step of the procedure. The suction ring will be forced
downward by the additional weight of the disposable
lens, raising the IOP by pressing the suction ring
against the patient’s eye until the lens is locked and
the weight is removed. In addition, strong forces
against the suction on the eye from patient movements
might further increase the IOP under suction. The sys-
tem monitors lateral and vertical forces continually
during docking and treatment and provides feedback
to the surgeon to minimize them. It will automatically
stop treatment and release the suction and the patient
when the force applied exceeds a safety threshold. Be-
yond that, the absence of amaurosis indirectly con-
firms a limited additional IOP rise.
Results of IOP measurements during femtosecond
laser–assisted cataract surgery with an applanating
or direct curved lens model are also not available.
Figure 2. Intraocular pressure measured at different time points dur-
ing the cataract treatment (1 hour postoperative Z IOP measured The only published data report a negligible pressure
1 hour after surgery on sitting patients; after femto with suction Z increase 2 weeks and 4 weeks after surgery.30
IOP measured after laser procedure with suction ring in place and Several previous studies analyzed IOP variations
with applied vacuum on lying patients; after femto without suction during corneal flap creation with a femtosecond laser
Z IOP measured 1 minute after vacuum turned off and suction ring using flat and curved contact lenses. As described, in
removed on lying patients; before suction Z IOP measured before
laser treatment on lying patients; preoperative Z IOP measured experimental setups with enucleated porcine globes,
2 days before surgery on sitting patients; with suction Z IOP mea- the maximum mean IOP with flat and curved lenses
sured after applying vacuum to suction ring on lying patients). was 65 G 20 mm Hg (Visumax), 135 G 16 mm Hg

J CATARACT REFRACT SURG - VOL 39, JANUARY 2013


26 IOP DURING LASER-ASSISTED CATARACT SURGERY USING A FLUID-FILLED INTERFACE

(Intralase), 205 G 32 mm Hg (Femtec), and 184 G 3. Friedman NJ, Palanker DV, Schuele G, Andersen D,
28 mm Hg (Femto LDV).11 In contrast, the fluid- Marcellino G, Seibel BS, Batlle J, Feliz R, Talamo JH,
Blumenkranz MS, Culbertson WW. Femtosecond laser capsu-
filled suction device used in this study led to a signifi- lotomy. J Cataract Refract Surg 2011; 37:1189–1198
cantly lower IOP increase, which might in turn lead to 4. Nagy ZZ, Kra nitz K, Takacs AI, Miha ltz K, Kova cs I, Knorz MC.
a lower complication rate. Comparison of intraocular lens decentration parameters after
The pressure increase immediately after the laser femtosecond and manual capsulotomies. J Refract Surg 2011;
treatments may be traced to volume changes created 27:564–569
5. Kra nitz K, Takacs A, Miha  ltz K, Kova cs I, Knorz MC, Nagy ZZ.
by the gas development in the lens during laser treat- Femtosecond laser capsulotomy and manual continuous curvi-
ment. Because gas leakage from the lens and into the linear capsulorrhexis parameters and their effects on intraocular
anterior chamber has been observed and because of lens centration. J Refract Surg 2011; 27:558–563
the relatively low increase in IOP, it is to be expected 6. Miha ltz K, Knorz MC, Alio  JL, Taka  Kra
 cs AI, nitz K, Kovacs I,
that no great damage will occur to the eye when this Nagy ZZ. Internal aberrations and optical quality after femtosec-
ond laser anterior capsulotomy in cataract surgery. J Refract
fluid-filled interface is used. Surg 2011; 27:711–716
In addition, the fluid-filled interface used in this 7. Ecsedy M, Miha  ltz K, Kova
 cs I, Taka  Filkorn T, Nagy ZZ.
 cs A,
study provides an unaltered view of the anterior eye Effect of femtosecond laser cataract surgery on the macula.
out past the limbus while limiting conjunctival hemor- J Refract Surg 2011; 27:717–722
rhage. The limbal suction has been shown not to 8. Nagy Z, Takacs A, Filkorn T, Sarayba M. Initial clinical evalua-
tion of an intraocular femtosecond laser in cataract surgery.
produce corneal folds, such as may occur when J Refract Surg 2009; 25:1053–1060
corneal-contact patient interfaces are used.B 9. Chaurasia SS, Luengo Gimeno F, Tan K, Yu S, Tan DT,
In conclusion, the fluid interface opens the possibi- Beuerman RW, Mehta JS. In vivo real-time intraocular pressure
lity of treating older cataract patients with a femtosec- variations during LASIK flap creation. Invest Ophthalmol Vis Sci
ond laser with a minimal increase in IOP. The 2010; 51:4641–4645. Available at: http://www.iovs.org/content/
51/9/4641.full.pdf. Accessed October 25, 2012
combination of low IOP and minimal anatomic 10. Herna  ndez-Verdejo JL, Teus MA, Roma  n JM, Bolıvar G. Por-
changes during the treatment might lead to fewer cine model to compare real-time intraocular pressure during LA-
complications and a better visual outcome. Unlike SIK with a mechanical microkeratome and femtosecond laser.
most refractive surgery patients, those with cataract Invest Ophthalmol Vis Sci 2007; 48:68–72. Available at: http://
typically present with accompanying conditions, www.iovs.org/cgi/reprint/48/1/68. Accessed October 25, 2012
11. Vetter JM, Holzer MP, Teping C, Weinga € rtner WE, Gericke A,
such as elevated IOP and various retinopathies. Stoffelns B, Pfeiffer N, Sekundo W. Intraocular pressure during
Raising the IOP may iatrogenically compromise these corneal flap preparation: comparison among four femtosecond
patients with multiple morbidities. More studies are lasers in porcine eyes. J Refract Surg 2011; 27:427–433
needed to quantify improvements in vision and 12. Dick HB, Willert A, Elling M. Real-time measurement of intraoc-
changes in the rate of complications. ular pressure during femtosecond laser enabled keratoplasty
[letter]. J Refract Surg 2011; 27:399–400
13. Groh MJ, Michelson G, Langhans MJ, Harazny J. Influence of
age on retinal and optic nerve head blood circulation. Ophthal-
WHAT WAS KNOWN mology 1996; 103:529–534
 Flat and curved applanating patient interfaces can cause 14. Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA.
high IOP during femtosecond laser surgery, such as in Recent patterns of medication use in the ambulatory adult pop-
ulation of the United States; the Slone survey. JAMA 2002;
LASIK flap cutting.
287:337–344. Available at: http://jama.jamanetwork.com/data/
Journals/JAMA/4816/JOC11123.pdf. Accessed October 25,
2012
WHAT THIS PAPER ADDS 15. Quigley HA, Vitale S. Models of open-angle glaucoma preva-
 The fluid-filled interface showed a considerably lower lence and incidence in the United States. Invest Ophthalmol
Vis Sci 1997; 38:83–91. Available at: http://www.iovs.org/
increase in IOP, which makes it safer to use for cataract
content/38/1/83.full.pdf. Accessed October 25, 2012
patients. 16. The Eye Diseases Prevalence Research Group. Prevalence of
age-related macular degeneration in the United States. Arch
Ophthalmol 2004; 122:564–572. Available at: http://archopht.
jamanetwork.com/data/Journals/OPHTH/9922/EEB30090.pdf.
Accessed October 25, 2012
REFERENCES 17. Rodrıguez-Galietero A, Gonza  lez Martınez JV, Del Buey A, 
1. Kelman CD. Phaco-emulsification and aspiration; a new tech- Besco  Use of brimonidine before LASIK with femtosec-
s JAC.
nique of cataract removal; a preliminary report. Am J Ophthalmol ond laser-created flaps for the correction of myopia: a contralat-
1967; 64:23–35 eral eye study. J Refract Surg 2010; 26:28–32
2. Behndig A, Montan P, Stenevi U, Kugelberg M, Lundstro €m M. 18. Arevalo JF, Lasave AF, Torres F, Suarez E. Rhegmatogenous
One million cataract surgeries: Swedish National Cataract retinal detachment after LASIK for myopia of up to 10 diopters:
Register 1992–2009. J Cataract Refract Surg 2011; 37: 10 years of follow-up. Graefes Arch Clin Exp Ophthalmol 2012;
1539–1545 250:963–970. Available at: http://www.springerlink.com/

J CATARACT REFRACT SURG - VOL 39, JANUARY 2013


IOP DURING LASER-ASSISTED CATARACT SURGERY USING A FLUID-FILLED INTERFACE 27

content/lpm880x64798642m/fulltext.pdf. Accessed October 25, surgery with integrated optical coherence tomography. Sci
2012 Transl Med 2010; 2:58ra85. Available at: http://www.stanford.
19. Cameron BD, Saffra NA, Strominger MB. Laser in situ edu/wpalanker/publications/fs_laser_cataract.pdf. Accessed
keratomileusis-induced optic neuropathy. Ophthalmology October 25, 2012
2001; 108:660–665 28. Kohlhaas M, Spo €rl E, Bo
€ hm AG, Pollack K, Sandner D,
20. Arevalo JF, Mendoza AJ, Velez-Vazquez W, Rodriguez FJ, Pillunat LE. Applanationstonometrie bei Normalpatienten und
Rodriguez A, Rosales-Meneses JL, Yepez JB, Ramirez E, Patienten nach LASIK [Applanation tonometry in “normal” pa-
Dessouki A, Chan CK, Mittra RA, Ramsay RC, Garcia RA, tients and patients after LASIK]. Klin Monatsbl Augenheilkd
Ruiz-Moreno JM. Full-thickness macular hole after LASIK for 2005; 222:823–826
the correction of myopia. Ophthalmology 2005; 112:1207–1212 29. Allen MJ, Wertheim GJ. Calibration of the Schiotz tonometer.
21. Principe AH, Lin DY, Small KW, Aldave AJ. Macular hemorrhage Am J Optom Arch Am Acad Optom 1964; 41:476–480
after laser in situ keratomileusis (LASIK) with femtosecond laser 30. Bali SJ, Hodge C, Lawless M, Roberts TV, Sutton G. Early expe-
flap creation. Am J Ophthalmol 2004; 138:657–659 rience with the femtosecond laser for cataract surgery. Ophthal-
22. Pavlin CJ, McWhae JA, McGowan HD, Foster FS. Ultrasound mology 2012; 119:891–899
biomicroscopy of anterior segment tumors. Ophthalmology
1992; 99:1220–1228 OTHER CITED MATERIAL
23. Uy HS, Edwards K, Curtis N. Femtosecond phacoemulsification: A. Talamo JH, Culbertson WW, Gooding P, Angeley D, Steinert
the business and the medicine. Curr Opin Ophthalmol 2012; RF, “Optical Impact and Clinical Significance of Corneal Fold
23:33–39 Formation in Laser Cataract Surgery,” presented at the annual
24. Gharaei H, Kargozar A, Raygan F, Daneshvar R. Comparison of meeting of the American Academy of Ophthalmology, Orlando,
Perkins, Tono-Pen and Schiotz tonometers in paediatric pa- Florida, USA, October 2011
tients under general anaesthesia. East Mediterr Health J 2008; B. Talamo JH, Culbertson WW, Batlle JF, Feliz R, Blumenkranz
14:1365–1371. Available at: http://applications.emro.who.int/ MS, Gooding PH, “Optical Interface Characteristics for Laser
emhj/1406/14_6_2008_1365_1371.pdf. Accessed October 25, Cataract Surgery” presented at the ASCRS Symposium on Cat-
2012 aract, IOL and Refractive Surgery, San Diego, California, USA,
25. Krieglstein GK, Waller WK. Goldmann applanation versus hand- March 2011
applanation and Schio €tz indentation tonometry. Albrecht von
Graefes Archiv Klin Exp Ophthalmol 1975; 194:11–16
26. Jackson CRS. Schio €tz tonometers; an assessment of their useful-
First author:
ness. Br J Ophthalmol 1965; 49:478–484. Available at: http://www.
Tim Schultz, MD
ncbi.nlm.nih.gov/pmc/articles/PMC506145/pdf/brjopthal00381-
0030.pdf. Accessed October 25, 2012 Center for Vision Science, Ruhr
27. Palanker DV, Blumenkranz MS, Andersen D, Wiltberger M, University Eye Clinic, Bochum,
Marcellino G, Gooding P, Angeley D, Schuele G, Woodley B, Germany
Simoneau M, Friedman NJ, Seibel B, Batlle J, Feliz R,
Talamo J, Culbertson W. Femtosecond laser-assisted cataract

J CATARACT REFRACT SURG - VOL 39, JANUARY 2013

View publication stats

Potrebbero piacerti anche