Microsurgery had its origins in ocular surgery. The development of the operating microscope and its accessories and complementary instruments, such as the surgical ophthalmometer, is reviewed from 1876 to the present.

History, 20th Century↗

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Coralline hydroxyapatite keratoprosthesis in rabbits.

BACKGROUND: The ideal keratoprosthesis will have a curvature similar to that of the recipient cornea and allow the tissue to grow into the supporting material. We developed a support for a keratoprosthesis made of porous hydroxyapatite, which is highly biocompatible, biointegrable, non-biodegradable, and colonizable. METHODS: We implanted the keratoprosthesis unilaterally in the right eyes of 12 New Zealand rabbits, intralamellarly and between a homologous episclerokeratoplasty (with and without conjunctival flap) for 12 months. Pathology studies and technetium-99 bone scans were performed. RESULTS: We found good vascularization, no signs of infection or extrusion, no epithelial downgrowth, and no adverse tissue reaction. CONCLUSION: A clinical trial of this keratoprosthesis is warranted.

Animals↗

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Permalens hydrogel intracorneal lenses for spherical ametropia.

PURPOSE: To assess the efficacy, stability, and safety of Permalens hydrogel intracorneal lenses for the correction of spherical ametropia 6 years after implantation. METHODS: Implantation of intracorneal hydrogel lenses was performed by the same surgeon (JIBM) in five aphakic and five high myopic eyes. The lens closet to corneal vertex refraction was used. Refractive outcomes, keratometry, keratography, endothelial cell count, and corneal topography were studied. RESULTS: Corneal tolerance to the hydrogel implants was maintained throughout for 6 years with no alteration in endothelial cell count. All myopic eyes showed regression of achieved correction. The aphakic eyes showed no statistically significant difference between the results at 1 month and those obtained at 1 and 6 years. CONCLUSIONS: Hyrdogel intracorneal lenses are well tolerated and the refractive results are stable in aphakic patients. They may be considered when intraocular lenses cannot be placed in aphakic patients, but are not now in clinical use.

Adult↗

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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. All surgery and follow-up examinations were performed in Bogota, Columbia. The mean preoperative spherical refraction was -14.00 +/- 5.00 diopters (range, -9.5 to -19.00 D). RESULTS: Corrections of up to 13.00 D were achieved. Corrections deviated from the predicted correction by a mean of -5.00 +/- 2.10 D (range, -2.80 to -8.00 D). No significant surgical or postoperative complications were noted. Visual recovery was rapid, usually achieving maximum acuity within 1 month. CONCLUSIONS: Successful myopic refractive changes were accomplished in all five human subjects. The major problem with the study to date has been a significant undercorrection of the preoperative refraction. We anticipate that further empirically derived relationships between hydrogel lens power and refractive change will allow a more accurate prediction of refractive result. Also, the ability to surgically interchange myopic hydrogel inlays should allow correction of any residual refractive errors.

Corneal Stroma↗

PubMedDate not supplied

Basis of refractive keratoplasty--1967.

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Cornea↗

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Transient descemetocele following radial keratotomy.

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Adult↗