MULTIFOCAL INTRAOCULAR LENSES: THE ART AND PRACTICE

The increased safety of cataract surgery and the evolution of intraocular lenses (IOLs) and their implantation techniques have led many physicians to begin offering so-called “premium IOLs” to selected patients.

But how does one get started? Where can one find the information necessary to select the right IOL for the right patients? Many books on the topic have appeared, but few seem to offer a comprehensive overview of how to successfully eliminate pseudophakic presbyopia.

Multifocal Intraocular Lenses: The Art and the Practice (Springer), edited by Jorge L Alió and Joseph Pikkel, has stepped in to fill this void. “Guidance is provided on types and models of intraocular lens, indications, selection of patients, implantation, neuroadaptation, and complications and their avoidance,” says the foreword.

The treatment of pseudophakic presbyopia is highly science, from the design of the IOLs and their precise implantation, to the neuroadaptation required for patients’ adjustment to the new sensory input. This material is adequately covered in the early chapters.

Despite the scientific design of the IOLs and complicated neurophysiology underpinning their performance, successful implantation often relies heavily on the psychology involved in satisfying the patient. Chapter 7, “Solutions for the Unhappy Patient”, addresses this complex manipulation of science and art. Most chapters, however, address the types, models and clinical use of the commercially available multifocal IOLs. This book is particularly useful for cataract surgery fellows, early-career ophthalmologists and experienced cataract surgeons who are interested in offering their patients the multifocal option.

ENDOTHELIAL KERATOPLASTY

Endothelial keratoplasty has long since replaced penetrating keratoplasty for the most common endothelial diseases. A series of modifications, from DLEK to DSEK, have led to vastly improved surgical rehabilitation and outcomes.

Standardized ‘no-touch’ DMEK is the next step for corneal surgeons, but attempting an entirely new technique is a daunting proposal. How to Get Started With Standardized ‘No-Touch’ Descemet Membrane Endothelial Keratoplasty (DMEK) (NIIOS/Sidestone Press), by Gerrit Melles & Isabel Dapena, is a good place to start.

The text covers the entire process: surgical indications, tissue preparation, surgical technique, clinical outcomes, complications, repeat DMEK and clinical case examples. Particularly useful is the selection of surgical “Dos” and “Don’ts”. This book is intended for corneal fellows or specialists considering the next step in endothelial surgery.