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CORNEA Fourth Edition cornea Mark J. Mannis MD FACS Natalie Fosse Endowed Chair in Vision Science Research Professor and Chair Department of Ophthalmology & Vision Science University of California Davis Eye Center Sacramento, CA, USA Edward J. Holland MD Director of Cornea Cincinnati Eye Institute Professor of Ophthalmology University of Cincinnati Cincinnati, OH, USA Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2017 © 2017, Elsevier Inc. All rights reserved. First edition 1997 Second edition 2005 Third edition 2011 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Csaba L Mártonyi and Mark Maio retain copyright for their original illustrations in Chapter 7. Michael E. Snyder retains copyright for his original figures and video clips in Chapter 145. Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. ISBN: Print: 978-0-323-35757-9 E-book: 978-0-323-35758-6 Inkling: 978-0-323-35759-3 Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 The publisher’s policy is to use paper manufactured from sustainable forests Content Strategist: Russell Gabbedy Content Development Specialist: Sharon Nash Content Coordinator: Joshua Mearns Project Manager: Joanna Souch Design: Christian Bilbow Illustration Manager: Emily Costantino Marketing Manager: Melissa Fogarty Video Table of Contents Clip Clip title Video contributor/s 50.1 The Application of Cryopreserved Amniotic Membrane in the Treatment Darren G. Gregory of Acute Stevens–Johnson Syndrome: Part 1 50.2 The Application of Cryopreserved Amniotic Membrane in the Treatment Darren G. Gregory of Acute Stevens–Johnson Syndrome: Part 2 50.3 The Application of Cryopreserved Amniotic Membrane in the Treatment Darren G. Gregory of Acute Stevens–Johnson Syndrome: Part 3 110.1 Penetrating Keratoplasty Using the Barron Trephine and Interrupted Mauricio A. Perez, David S. Rootman Sutures 110.2 Penetrating Keratoplasty Using the Hanna Trephine and Interrupted Mauricio A. Perez, David S. Rootman Sutures 110.3 Penetrating Keratoplasty Using the Slipknot Technique for Suturing Clara C. Chan, Mauricio A. Perez 110.4 Penetrating Keratoplasty Using a Running Suture Mauricio A. Perez, Allan R. Slomovic 111.1 An Intraoperative Suprachoroidal Hemorrhage During Penetrating Michael C. Chen, Mark J. Mannis Keratoplasty, which was Successfully Managed with the Assistance of a Cobo Temporary Keratoprosthesis 112.1 Donor Preparation Marjan Farid, Roger F. Steinert, Sumit Garg, Matthew Wade 112.2 Dissection and Suturing Marjan Farid, Roger F. Steinert, Sumit Garg, Matthew Wade 112.3 Laser Incision Marjan Farid, Roger F. Steinert, Sumit Garg, Matthew Wade 112.4 Femto DALK Marjan Farid, Roger F. Steinert, Sumit Garg, Matthew Wade 117.1 Big Bubble DALK: A Video Presentation Mohammad Anwar 118.1 Techniques of Anterior Lamellar Keratoplasty: Stromal Delamination Luigi Fontana 118.2 Techniques of Anterior Lamellar Keratoplasty: ALTK 1 Luigi Fontana 118.3 Techniques of Anterior Lamellar Keratoplasty: ALTK 2 Luigi Fontana 118.4 Techniques of Anterior Lamellar Keratoplasty: Big Bubble Luigi Fontana 118.5 Techniques of Anterior Lamellar Keratoplasty: Big Bubble Using Luigi Fontana a Cannula 118.6 Techniques of Anterior Lamellar Keratoplasty: Donor Preparation Luigi Fontana 119.1 Rupture of DM in a Keratoconus Patient Shigeto Shimmura 120.1 Cannula Big-Bubble Technique, Bubble Test, and the New Opening of Vincenzo Sarnicola, Enrica Sarnicola, the Bubble Caterina Sarnicola 120.2 Air-Viscobubble Technique (AVB) Vincenzo Sarnicola, Enrica Sarnicola, Caterina Sarnicola 120.3 Layer-by-Layer Manual Dissection Vincenzo Sarnicola, Enrica Sarnicola, Caterina Sarnicola 120.4 dDALK Rupture Management Vincenzo Sarnicola, Enrica Sarnicola, Caterina Sarnicola 120.5 Subtotal Full Thickness Circular Cut of the Recipient Bed Vincenzo Sarnicola, Enrica Sarnicola, Caterina Sarnicola xi Video Table of Contents Clip Clip title Video contributor/s 120.6 Total Full Thickness Circular Cut of the Recipient Bed Vincenzo Sarnicola, Enrica Sarnicola, Caterina Sarnicola 120.7 Excessive Trephination and Perforation Vincenzo Sarnicola, Enrica Sarnicola, Caterina Sarnicola 120.8 Traumatic Postoperative DM Disinsertion Vincenzo Sarnicola, Enrica Sarnicola, Caterina Sarnicola 126.1 Eye Bank Preparation of DMEK Graft Tissue Using a Modified Mark A. Greiner, Gregory A. Schmidt, SCUBA Technique Kenneth M. Goins 130.1 Ultrathin DSAEK Massimo Busin, Vincenzo Scorcia 131.1 DMEK Injectors Michael D. Straiko 131.2 Peripheral Iridotomy Kevin J. Shah, Michael D. Straiko, Mark A. Greiner 132.1 Torn Donor Graft During DMEK Graft Preparation Using Dagny Zhu, Neda Shamie SCUBA Technique 134.1 DSEK Under Top Hat PKP with Laplace Phenomenon Matthew T. Feng, Francis W. Price, Jr., Marianne O. Price 134.2 Suture Pull Through and Fixation Matthew T. Feng, Francis W. Price, Jr., Marianne O. Price 136.1 RHCIII Implantation Surgery May Griffith, Oleksiy Buznyk, Per Fagerholm 141.1 Primary Pterygium Excision and Conjunctival Autograft with Fibrin Glue Donald T.H. Tan, Elaine W. Chong 141.2 Recurrent Pterygium Excision and Extensive Tenon’s Excision with Donald T.H. Tan, Elaine W. Chong Conjunctival Autograft Using Fibrin Glue 143.1 How to Know the Orientation of the Amniotic Membrane Jose L. Güell, Oscar Gris, Daniel Elies, Felicidad Manero, Merce Morral 143.2 Surgical Videos of Several Cases where Amniotic Membrane Jose L. Güell, Oscar Gris, Daniel Elies, Transplantation was Performed Felicidad Manero, Merce Morral 143.3 The Modified Gundersen Approach Consists of Four Main Steps Jose L. Güell, Oscar Gris, Daniel Elies, Felicidad Manero, Merce Morral 143.4 Two-Step Approach to Treat Unilateral Total Limbal Stem Cell Jose L. Güell, Oscar Gris, Daniel Elies, Deficiency Felicidad Manero, Merce Morral 145.1 Iris Oversew Michael E. Snyder, Jason H. Bell 145.2 Taco Down Fold of PCIOL for Insertion Behind 50-Series Iris Prostheses Michael E. Snyder, Jason H. Bell 145.3 CustomFlex Iris Device Injection and Capsular Bag Implantation Michael E. Snyder, Jason H. Bell With Overfolding 151.1 KPro Assembly and Surgery Jose de la Cruz 155.1 Boston Keratoprosthesis Type 2 Surgical Techniques Duna Raoof, James Chodosh 156.1 Stage 1 OOKP Jean S.M. Chai, Donald T.H. Tan 156.2 Stage 2 OOKP Jean S.M. Chai, Donald T.H. Tan 158.1 LR-CLAU Edward J. Holland, Gary S. Schwartz, Sheraz M. Daya, Ali R. Djalilian, Clara C. Chan 158.2 KLAL Edward J. Holland, Gary S. Schwartz, Sheraz M. Daya, Ali R. Djalilian, Clara C. Chan 158.3 CLAU-KLAL Modified Cincinnati Procedure Edward J. Holland, Gary S. Schwartz, Sheraz M. Daya, Ali R. Djalilian, Clara C. Chan 160.1 Combined LR-CLAL/KLAL (Cincinnati Procedure) Followed by Kevin J. Shah, Edward J. Holland, Penetrating Keratoplasty Mark J. Mannis 165.1 LASEK Azar Flap Technique Dimitri T. Azar, Ramon C. Ghanem 166.1 Technique for Custom Femtosecond LASIK Louis E. Probst 167.1 Femtosecond LASIK Patricia B. Sierra, David R. Hardten xii Video Table of Contents Clip Clip title Video contributor/s 169.1 Anterior Chamber Gas Bubbles Blocking the Tracking of the Pupil Louis E. Probst, Clara C. Chan, Mario J. Saldanha 171.1 Small Incision Lenticule Extraction Jodhbir Mehta 172.1 Post LASIK Ectasia – Intrastromal CXL and Ring Adimara da Candelaria Renesto, Mauro Campos 173.1 Femtosecond Laser Astigmatic Keratotomy Zaina Al-Mohtaseb, Leela V. Raju, Li Wang, Mitchell P. Weikert, Douglas D. Koch 174.1 Implantation of an Artisan Lens Thomas Kohnen, Mehdi Shajari, Jose L. Güell, Daniel Kook, Rudy M.M.A. Nuijts 174.2 Implantation of a Toric Artisan Lens Thomas Kohnen, Mehdi Shajari, Jose L. Güell, Daniel Kook, Rudy M.M.A. Nuijts 174.3 Implantation of an Artiflex Lens Thomas Kohnen, Mehdi Shajari, Jose L. Güell, Daniel Kook, Rudy M.M.A. Nuijts 174.4 Implantation of an ICL Thomas Kohnen, Mehdi Shajari, Jose L. Güell, Daniel Kook, Rudy M.M.A. Nuijts 174.5 Performing LASIK in a Patient with an Iris-Fixated Lens Thomas Kohnen, Mehdi Shajari, Jose L. Güell, Daniel Kook, Rudy M.M.A. Nuijts 175.1 Implanting the Kamra Small-Aperture Inlay Richard L. Lindstrom, Jay S. Pepose, John A. Vukich Total video running time: 2 hours 41 minutes xiii Preface The subspecialty of cornea and external disease has under- new surgical videos in order to keep pace with the dramatic gone significant transformation since the last edition of innovation in our field. The editors and authors have strived Cornea. New diagnostic technology has vastly improved our to provide the most current material available for residents, ability to detect disease. New medications and other thera- fellows, clinicians, and researchers to help in the manage- peutic options have changed the treatment paradigm for ment of patients with cornea and external disease. We hope many disorders. And new surgical techniques have had a this edition will benefit patients for years to come. remarkable impact on surgical outcomes. Not only do these new procedures provide better outcomes but, in addition, Mark J. Mannis we can now offer surgical options earlier in the disease process. Edward J. Holland This edition of Cornea consists of numerous new chapters and extensive revisions of existing chapters, as well as many xiv Acknowledgements This fourth edition of Cornea is the result of an extraordinary, highest quality medical textbook possible both in print and coordinated effort by many talented individuals. We cannot electronic format. Special thanks to Sharon Nash and Russell thank our contributing authors and co-authors enough. We Gabbedy at Elsevier, who have motivated and guided us appreciate their excellent contributions of the most current along this journey. information on the diagnosis and management of cornea Finally, we would like to thank our families, who continue and external disease. In addition, we thank these authors for to provide support and the considerable time needed to adhering to the tight editorial requirements in order to keep produce what we hope is an outstanding textbook. this textbook current and on time. We have enjoyed our continued relationship with our publisher, Elsevier, who shares our goal: to provide the xv We dedicate this book to patients suffering from corneal blindness that we cannot help at this time but hope to be able to help in the future. Mark J. Mannis Edward J. Holland
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