tailieunhanh - Refractive Lens Surgery (part 8)

Một ống kính pseudophakic có thể được không xâm lấn điều chỉnh hoặc điều chỉnh sau cấy sẽ cho phép độ chính xác cực trong các kết quả khúc xạ cuối cùng. Lý tưởng nhất, ống kính này sẽ có khả năng được điều chỉnh một cách chính xác | 162 The Ideal Pseudophakic Lens A pseudophakic lens that could be non-inva-sively adjusted or fine-tuned following implantation would allow for extreme accuracy in the final refractive outcome. Ideally this lens would have the ability to be precisely adjusted using a non-toxic external light source and allow for several diopters of myopic hyperopic or astigmatic correction should a postoperative refractive surprise occur. Micron-precision adjustment would allow for the possibility of modifying not only the lower-order aberrations of sphere and cylinder but also higher-order optical aberrations such as coma and spherical aberration. The lens should be stable following adjustment and composed of a safe biocompatible material. In addition a foldable lens that could be inserted through a clear corneal incision would insure control of surgically induced astigmatism 8 . Finally if possible an injectable flexible polymer design that could be injected through a 1-mm incision would further reduce any surgically induced astigmatism or higher-order corneal aberrations and conceivably depending on its final elasticity could return accommodative ability to the lens ciliary body apparatus. Light-Adjustable Lens This ideal lens technology is no longer science fiction and is currently being developed by Calhoun Vision Pasadena CA USA . It is termed the light-adjustable lens LAL Fig. . The current design of the LAL is a foldable three-piece IOL with a cross-linked photosensitive silicone polymer matrix a homogeneously embedded photosensitive macromer and a photoinitiator. The application of near-ultraviolet UV light to a portion of the lens optic results in disassociation of the photoinitiator to form reactive radicals that initiate polymerization of the photosensitive macromers within the irradiated region Fig. . Calhoun Vision s light-adjustable lens LAL . Courtesy of Calhoun Vision Inc. of the silicone matrix. .

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