10. Retinal Image magnification in hyperopia Decreased retinal image size will result in a decrease in BSCVA Refraction Vertex distance Change in retinal image size Ratio retinal image size glasses/Rx surgery Theoretical VA after corneal Rx surgery +4.00 D 12 mm -4.8% 0.95 20/21 +4.00 D 16 mm -6.4% 0.94 20/21 +7.00 D 12 mm -8.4% 0.92 20/22 +7.00 D 16 mm -11.2% 0.89 20/23
39. Example: Hyperopic Postop - OD Patient’s subjective symptoms OD Wavefront (Pupil Centre ) Visual Symptoms do NOT match PSF by wavefront ( pupil centre)
40. Example: Hyperopic Postop - OD Patient’s subjective symptoms OD Wavefront (Corneal Vertex) Visual Symptoms DO match PSF by wavefront ( corneal vertex)
44. Excimer Laser for Hyperopia: What Are Age and Degree Limits? Dan Z Reinstein MD MA(Cantab) FRCSC FRCOphth 1,2,3,4 ’ ’ Thank You
87. Complications: Pupil ovalisation Alio et al – The Kelman duet phakic intraocular lens: 1-year results – J Refract Surg. 2007;23(9):868-79
88. Complications: Cataract Formation Garcia-Feijoo et al – JCRS – 2003;29:1932-39 Brandt JD et al – Am J Ophthalmology 2001;131:260-263 Alio et al – Angle-supported anterior chamber phakic intraocular lens explantation causes and outcome. Ophthalmology 2006;113(12): 2213-20
115. Excimer Laser for Hyperopia: Wider Limits Dan Z Reinstein MD MA(Cantab) FRCSC FRCOphth 1,2,3,4 1. London Vision Clinic, London, UK 2. St. Thomas’ Hospital - Kings College, London, UK 3. Weill Medical College of Cornell University, New York, USA 4. Centre Hospitalier National d’Ophtalmologie, (Pr. Laroche), Paris, France
First, I’m going to quickly outline the outcomes of the cross linking treatments done at the London Vision Clinic
First, I’m going to quickly outline the outcomes of the cross linking treatments done at the London Vision Clinic
First, I’m going to quickly outline the outcomes of the cross linking treatments done at the London Vision Clinic
First, I’m going to quickly outline the outcomes of the cross linking treatments done at the London Vision Clinic
Update numbers
First, I’m going to quickly outline the outcomes of the cross linking treatments done at the London Vision Clinic
Here are some examples of right and left pairs of ICL implanted into patients, based on the traditional white-to-white prediction algorithms. In this image we see two perfectly vaulted lenses, left and right, in an eye with WTW of 11.5 on both sides.
This case, shows that despite the same WTW on both sides, the vault was excessive on the right, but non-existent on the left.
In this eye, the WTW was different on both sides, but the lenses were oversized on both sides by about the same amount.
This case shows a patient after implantation of an Artisan phakic IOL. On the left you see a digital image of the implanted lens. The red circle marks the pupil center and the grey circle marks the lens optic. Shown on the right is the wavefront measurement with the WASCA Analyzer. Especially after refractive procedures which didn‘t modify corneal curvature, i.e. phakic IOLs etc.., wavefront analysis is an indispensable diagnostic instrument. The spherical surfaces of the Artisan IOL cause a small amount of spherical aberration Z(4,0) of –0,5µm. This is a result of the spherical lens surfaces and can be also found in standard IOL. Although the lens seems to be well centered, the coma of -1,38µm must be the result of the lens centration. In this case the WASCA result clearly confirmed the poor vision of the patient. Because of the corresponding subjective and objective findings the lens has been repositioned to improve the visual outcome.
Here you see the situation after repositioning of the lens. On the left you see again the digital image of the implanted lens. The circles show that the center of the lens is not pupil centered anymore. Shown on the right is the wavefront measurement with the WASCA Analyzer. The coma coefficient has been decreased to -0,59µm due to the repositioning. The patients visual perfromance improved dramatically. This encourages us to perform wavefront measurement on all problem patients.
First, I’m going to quickly outline the outcomes of the cross linking treatments done at the London Vision Clinic
First, I’m going to quickly outline the outcomes of the cross linking treatments done at the London Vision Clinic
This example shows a hyperopic patient where the post op result was close to plano, however, both eyes could see N6 at near A 59 year old patient would only be expected to see N6 at near with an add of around -1.50 to -2.00 D
Successful high plus treatment
Getting N6 from just -0.75 cyl in a 60 year old patient
First, I’m going to quickly outline the outcomes of the cross linking treatments done at the London Vision Clinic
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