Multiple component intraocular lens: first human implantation.

Purpose: To report the first clinical implantation of a foldable, spherical multiple component intraocular lens (MC-IOL). Previous studies and publications described a polymethylmethacrylate version of this lens, which required a 7-mm incision for its implantation. The foldable version of this lens system can be inserted through a < 3-mm incision.

Addressing uncompensated hospital services. Case study: physician revenue-enhancement program.

Traditionally, physicians have provided many uncompensated services to hospitals such as emergency room on-call duty, charity care and committee appointments. But physicians can no longer afford to give away services, and hospitals need their assistance to become more cost-efficient. This article describes an innovative physician-driven cost-management program that pays physicians for their hospital work and saves the hospital money.

Casebeer System for refractive keratotomy: patient satisfaction.

Purpose: To evaluate patient satisfaction 3 years after radical keratotomy (RK) using the Casebeer nomograms.

Setting: The Werblin Center, Princeton, West Virginia.

Methods: This study assessed the satisfaction of 96 patients who had bilateral distance correction by RK using the Casebeer System.

Hyperopic shift after refractive keratotomy using the Casebeer System.

Purpose: To determine the degree of hyperopic shift following refractive keratotomy.

Setting: The Werblin Center, Princeton, West Virginia.

Methods: The results of 241 consecutive radial/astigmatic keratotomy procedures in 128 patients were studied.

Three year results of refractive keratotomy using the Casebeer System.

Purpose: To analyze the results of one surgeon's first refractive keratotomy surgeries.

Setting: The Werblin Center, Princeton, West Virginia.

Methods: The three year results of 241 consecutive surgical procedures (128 patients) using Casebeer nomograms were examined.

Hexagonal keratotomy--should we still be trying?

Background: I present my limited but positive experience with hexagonal keratotomy for hyperopia.

Methods: Eighteen consecutive eyes of 12 patients underwent hexagonal keratotomy during 1993. In addition to the primary procedures, 14 enhancements were required in seven eyes for both astigmatism and undercorrection.

Multicomponent intraocular lens.

Background: Refractive surgery for any form of ametropia, including postoperative cataract rehabilitation, should have as its refractive goal an accuracy comparable to non-surgical modalities such as contact lenses and spectacles. To date, all refractive procedures fall significantly short of this goal because of poor predictability, significant instability, and annoying optical side effects. The multicomponent intraocular lens is being developed to further refine the accuracy of conventional IOL surgery by making the initial refractive result adjustable.

Do three-piece PMMA IOLs rotate after implantation in the capsular bag?

Background: With the current interest in toric intraocular lenses (IOLs), it is critical to establish whether these implants rotate following cataract surgery. If there is continual rotation of the implant with capsular bag contraction, then the orientation of the astigmatic correction would be unstable and thus not clinically useful.

Methods: Twenty-eight eyes were followed for up to 6 months postoperatively.

Refractive stability after cataract extraction using a 6.5-millimeter scleral pocket incision with horizontal or radial sutures.

Background: Radial suturing of 6.5-millimeter scleral tunnel incisions following cataract surgery can create significant with-the-rule astigmatism in the immediate postoperative period. Because of the significant visual distortion and slow visual recovery seen with radial suturing, this study was undertaken to compare two other suturing techniques which induce lesser amounts of with-the-rule astigmatism in the immediate postoperative period.

The Casebeer system for predictable keratorefractive surgery. One-year evaluation of 205 consecutive eyes.

Purpose: This study documents the results of current radial keratotomy (RK) surgical technology, using the Casebeer keratorefractive system. These results are contrasted to those of the Prospective Evaluation of Radial Keratotomy (PERK) keratorefractive system, developed approximately 12 years ago.

Methods: Two hundred five consecutive surgical procedures were examined, which was the first year of experience with RK for one of the authors (TPW).

Long-term endothelial cell loss following phacoemulsification: model for evaluating endothelial damage after intraocular surgery.

Background: Newer concepts of phakic intraocular lens (IOL) surgery present concerns as to their long-term deleterious effect on the endothelium. We examine the behavior of the endothelium for up to 6 years following uneventful phacoemulsification surgery, to establish a baseline for what might be an acceptable level of endothelial cell loss due to intraocular surgical trauma.

Methods: Ninety-three eyes undergoing phacoemulsification surgery who had multiple endothelial specular microscopy examinations for up to 6 years were examined.

Astigmatism after cataract extraction: 6-year follow up of 6.5- and 12- millimeter incisions.

Background: Cataract surgery and cataract surgeons have long realized that the surgical wound induces a significant change in the astigmatic properties of the eye postoperatively. In efforts to avoid or minimize these changes, there has been a progressive shift toward smaller incision sizes. However, that incision size which renders the eye astigmatically neutral has yet to be completely defined.

Initial human experience with Permalens myopic hydrogel intracorneal lens implants.

Background: Previous nonhuman primate experimentation has demonstrated the successful use of Permalens hydrogel intracorneal lens implants for the correction of hyperopic and myopic refractive errors. This article documents the first human experience with myopic Permalens hydrogel intracorneal lens implants.

Methods: In this article, we report an 18-month follow up on five patients implanted with minus power hydrogel intracorneal lenses.