IOL Intraocular Lens Calculations

Topography-based Power Adjustment Methods.

For RK, averaging the 0 mmm, 1 mm and 2 mm annular power rings of the Numerical View of the Zeiss Humphrey Atlas topographer (below) will typically a useful estimate of central corneal power. The Numerical View feature of the Zeiss Humphrey Atlas topographer. Transient hyperopia following cataract surgery and prior radial keratotomy Patients with previous 8-incision radial keratometry will commonly show variable amounts of hyperopia in the immediate post-operative period following cataract surgery. This is felt to be due to stromal edema in the areas of the radial incisions, producing a temporary enhancement of central corneal flattening. While this central corneal flattening is usually transient, it can be as much as +4.00 D, and is further accentuated by greater than eight incisions, or an optical zone of less than 2.0 mm. If a patient exhibits any of the above, significant unanticipated hyperopia may be seen in the immediate post-operative period, which should gradually resolve after eight to twelve weeks. Sometimes, due to a lack of corneal stability, the post-operative refraction can continue to slowly shift myopic over a several month period. We have seen several patients with myopic shifts as large a -5.00 D over a 12-week period. If the refractive objective remains elusive, plans for an IOL exchange, or a piggyback IOL, should not be made until at least two months have passed and two consecutive refractions, at the same time of the day, are stable. If more than six months passes before cataract surgery is required for the fellow eye, the corneal measurements should be repeated due to the fact that additional corneal flattening frequently occurs over time following radial keratotomy. For this reason, IOL power calculations are usually targeted for between -0.50 D and -1.00 D and are designed to make the operative eye more myopic than usual, so that five to ten years from now, the post-cataract surgery refractive error does not drift into hyperopia. This also helps to avoid hyperopic refractive results, which are quite common in spite of every precaution being taken.

Expert Witness Cataract Surgery Famous Renowned (Renown) Best Eye Surgeon California New Mexico Texas Nevada Arizona Top Doc World Renowned Class

2008-09-13 Expert Witness Eye Surgery Cataract Surgery Ophthalmology Eye Surgeon World Renowned (Renown) Famous Best Top Doc Ophthalmology expert witness: cataract surgery - medical, technical and scientific expert and consultant available worldwide. Top doc expert witness: world renowned expert witness in cataract eye surgery. An expert in all phases of ophthalmology especially neuro-ophthalmology, the eye as part of the brain, occupational/industrial ophthalmology; ophthalmology expert witness: visual impairment/disabilities; visual job essential functions, testing functions, standards; ocular safety/visual ergonomics; occupational ophthalmologist, comprehensive ophthalmology, laser vision correction, visual, ocular, brain, field, acuity injury/impairment, low vision, legal blindness, rehabilitation, Lasik, cornea, cataract, neuro-opthalmology, ophthalmology-pediatric, vision, ophthalmology expert witness: refractive, PRK, IOL, glaucoma, retina, blindness, ophthalmology, corneal transplant, corneal disease, cataract surgery, eye pathology, refractive surgery, expert in evaluating cataract, glaucoma, retina, trauma cases, clear objective opinions. A corneal and external ocular disease specialist including refractive surgery, blepharoplasty, eyelids, graves eye disease, lacrimal system, orbital diseases, orbital surgery, ptosis, tear drainage, retina, macula, eye, ophthalmology, macular degeneration, vitrectomy, laser photocoagulation, cataract surgery, ophthalmic visual disability, lasik, brain injury affecting visual functions; eye injury evaluation and causation; identify visual malingering. Ophthalmology expert witness: Macular degeneration, endophthalmitis, diabetic retinopathy, retinal detachments, retina and vitreous and uveitis specialist. Strabismus, amblyopia, congenital eye defects, visual processing learning disorders, pediatric cataracts, tumors. Ophthalmology, lasik surgery, cornea surgery, general ophthalmology, cataract, glaucoma, retina. Eye trauma, cataract, lens implant, glaucoma, lasik, eyelid surgery, blepharoplasty, cornea, laser. Medical and surgical ophthalmology. Medicolegal ophthalmology, IME, QME, and AME Other Specialty: Glaucoma. Treatment of diseases of the retina and vitreous. Ophthalmology expert witness: