Mastering Corneal Surgery

Amar Agarwal, MS, FRCS, FRCOphth, is the Chairman and Managing Director of Dr. Agarwal’s Group of Eye Hospitals and Eye Research Centre in India, which includes 60 hospitals worldwide; past President of the International Society of Refractive Surgery (ISRS); Secretary General of the Indian Intraocular Implant and Refractive Society (IIRSI); and Professor of Ophthalmology at Ramachandra Medical College in Chennai, India. Dr. Agarwal is the pioneer of phakonit, which is phacoemulsification with needle incision technology. This technique became popularly known as bimanual phaco, microincision cataract surgery (MICS), or microphaco. Dr. Agarwal was the first to remove cataracts through a 0.7-mm tip with the microphakonit technique. He also discovered no-anesthesia cataract surgery and FAVIT, a new technique to remove dropped nuclei. Using an aquarium fish pump to increase the fluid into the eye in bimanual phaco and coaxial phaco has helped prevent surge. This formed the basis of various techniques of forced infusion for small-incision cataract surgery. Dr. Agarwal also discovered a new refractive error called aberropia. He was the first to perform a combined surgery of microphakonit (700-µm cataract surgery) with a 25-gauge vitrectomy in the same patient, thus creating the smallest incisions possible for cataract and vitrectomy. He was the first surgeon to implant a new mirror telescopic intraoperative lens (IOL) for patients suffering from age-related macular degeneration. He was the first in the world to implant a glued IOL, in which a posterior-chamber IOL is fixed in an eye without capsules using fibrin glue. He modified the Malyugin ring (MicroSurgical Technology) for small-pupil cataract surgery into the Agarwal modification of the Malyugin ring for miotic pupil cataract surgeries with posterior capsular defects. Thomas John, MD, was born in India, and lived the majority of his life in the United States. His eye training consisted of an ophthalmology residency at the University of Pennsylvania and a 2-year clinical cornea fellowship at Harvard Medical School, Massachusetts Eye and Ear Infirmary. Dr. John’s academic pinnacle was in Boston, training under Drs. Kenyon, Foster, Steinert, Dohlman, Abelson, Langston, Wagoner, Gilbard, Boruchoff, and Bajart. His corneal research experience stems from Schepens Eye Research Institute and Massachusetts Institute of Technology (MIT), Harvard Medical School. He completed ophthalmic pathology training under Drs. Eagle, Rockey, and Yanoff during his National Institutes of Health (NIH) ophthalmic pathology fellowship.Dr. John is currently on the editorial boards of Ocular Surgery News (OSN), Review of Ophthalmology, and Ophthalmology Management, and was previously on the editorial boards of Annals of Ophthalmology (AO), Expert Review of Ophthalmology, and Optometry Management. He was Chief Editor of the Consultation Section of AO; Associate Editor of AO, Chief Editor, Corneal Dissection Column, OSN; and Editor, Journal Techniques in Ophthalmology. He is widely published in peer-reviewed journals and has edited many books, written many chapters, and made numerous presentations. He served as ASCRS panelist and poster judge and was Chief Film Festival Judge for ASCRS in 2013. He performed live surgery, descemetorhexis with endokeratoplasty, at the International Meeting of the Italian Ophthalmological Society in 2007 in Venice, Italy. He developed numerous surgical instruments and holds a patent on an ophthalmic device. He has delivered numerous surgical video presentations. His present book with Dr. Agarwal is an extension of his surgical interests in ophthalmology.

Dedication Acknowledgments About the Editors Contributing Authors Preface Foreword Introduction Section I Keratoplasty Chapter 1 Applied Anatomy and Physiology of the Cornea Chapter 2 Penetrating Keratoplasty Chapter 3 Automated Lamellar Therapeutic Keratoplasty Chapter 4 Deep Anterior Lamellar Keratoplasty Chapter 5 Descemet's Stripping Automated Chapter 6 Ultra-Thin Grafts for Descemet's Stripping Automated Endothelial Keratoplasty 7 Descemet's Membrane Endothelial Keratoplasty Chapter 8 Endoilluminator-Assisted Descemet's Membrane Endothelial Keratoplasty Chapter 9 Corneal Surgery and the Glued Intraocular Lens Technique Chapter 10 Pre-Descemet's Endothelial Keratoplasty Chapter 11 Corneal Graft Rejection Chapter 12 Femtosecond Laser–Assisted Corneal Graft Surgery Section II Keratoprosthesis and Ocular Surface Disorders Chapter 13 Boston Keratoprosthesis Chapter 14 Modified Osteo-Odonto-Keratoprosthesis MD Chapter 15 Foldable Nonpenetrating Artificial Cornea Chapter 16 Limbal Stem Cell Deficiency Chapter 17 Amniotic Membrane Transplantation Section III Corneal Surgery Related to Cataract Surgery Chapter 18 Limbal Relaxing Incisions Chapter 19 Femtosecond Laser Corneal Incisions Chapter 20 Intrastromal Arcuate Keratotomy to Reduce Corneal Astigmatism With a Femtosecond Laser Chapter 21 Descemet's Membrane Detachment: Classification and Management Chapter 22 Corneoscleral Pocket Technique Section IV Miscellaneous Chapter 23 Intrastromal Corneal Ring Segments and the Turnaround Technique for Overcoming False Channel Dissection During Intacs Implantation Chapter 24 Corneal Inlays for the Surgical Correction of Presbyopia Chapter 25 Pterygium Surgery: Raising Ocular Surface Surgery to Cosmetic Outcomes Chapter 26 Limbal Dermoids MD Chapter 27 Ocular Surface Squamous Neoplasia Chapter 28 Collagen Cross-Linking and Contact Lens–Assisted Collagen Cross-Linking for Corneal Ectatic Disorders Chapter 29 Platelet-Rich Plasma in Corneal Surgery Financial Disclosures Index