Applied Pathology for Ophthalmic Microsurgeons

Front Cover
Gottfried O.H. Naumann, L. Holbach, F.E. Kruse
Springer Science & Business Media, Apr 5, 2008 - Medical - 399 pages
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Ophthalmic microsurgery is applied in ophthalmic pathological conditions. Ophthalmic pathology sets the landmarks for all kinds of microsurgical manipulations. Thus, in order to ensure the best surgical outcome, ophthalmic clinicians and microsurgeons have to consider the critical structures and potential complications before they start with the surgical procedure.

Written by the world famous expert G. O. H. Naumann, this excellent textbook emphasizes the ocular structures such as the nuances of morphology, surgical anatomy, and pathology.

The content includes: Unique features of closed system intraocular surgery in closed system and open eye surgery.- Crucial aspects of restoring the anterior chamber, includes such as the role of blood-ocular barriers and effects of paracenthesis-effects. The spectrum of potential complications in (pseudo-) exfoliation- syndromes as well as the most vulnerable cell populations.- The features of normal and pathologic wound healing in the various tissues after non-mechanical laser and mechanical interventions emergency-pathology requiring prompt surgical intervention.

Brilliant artwork and sketches are further illustrating and summarizing the complex pathology. Thus, the reader will derive great value for the daily routine when learning how the specific pathology modifies the indications and techniques of microsurgery.

 

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Contents

Introduction
1
Ophthalmic Pathology also Connects Experimental and Clinical Ophthalmology
2
References see also page 379
6
General Ophthalmic Pathology Principal Indications and Complications Comparing Intra and Extraocular Surgery
7
Excess of Tissue
8
Neovascularization and Scars
9
Intraocular Compared with Extraocular Surgery Distinguishing Features and Potential Complications
11
Anterior Movement of the IrisLens Diaphragm Vis a Tergo
13
Surgical Pathology
182
Contusion Deformity
183
Pseudoadenomatous Hyperplasia Fuchs Adenoma
186
Epithelial Ingrowth Involving the Anterior Chamber Angle
193
Block Excision of Tumors and Epithelial Ingrowth of Anterior Uvea
195
Block Excision of Localized Tumors of the Anterior Uvea
204
Cyclodestruction
213
Wound Healing and Complications After Procedures Involving the Ciliary Body
215

Paracentesis Effect
14
Expulsive Choroidal Hemorrhage and Uveal Effusion
17
Purulent Endophthalmitis
18
Sympathetic Uveitis
19
Hemorrhage from Vasoproliferative Processes
21
Toxic Anterior Segment Syndrome TASS
22
Choice of Anesthesia and Knowledge of Ophthalmic Pathology
24
Instrumentation and Physical Principles
26
References see also page 379
27
Surgical Anatomy and Pathology in Surgery of the Eyelids Lacrimal System Orbit and Conjunctiva
29
Eyelids
30
Arterial Supply
32
Surgical Pathology
33
Surgical Pathology and Anatomic Principles of Ectropion Repair
34
Surgical Pathology and Anatomic Principles of Entropion and Distichiasis Repair
37
Surgical Pathology and Anatomic Principles of Blepharoptosis Repair
39
Eyelid Tumors
40
References see also page 379
44
Lacrimal Drainage System
45
Surgical Pathology
46
Principles of Lacrimal Surgery
47
External Dacryocystorhinostomy with Bypass Tube Insertion
48
Orbit
49
Surgical Pathology
50
ThyroidAssociated Orbitopathy Endocrine Orbitopathy Ophthalmopathy Graves Ophthalmopathy
62
Principles of Orbital Surgery
64
Lateral Orbitotomy
65
Evisceration
66
Conjunctiva and Limbus Corneae
67
Limbal Stem Cells Vogts Palisades Cornea Verticillata Tear Film
69
Hereditary Anomalies of the Conjunctiva Conjunctival Lymphangioma
70
Sarcoidosis and Conjunctival Involvement in Systemic Disease
71
Pterygium
72
Amniotic Membrane Transplantation
73
Dry Eye
74
Conjunctival Oncology Melanocytic Processes
75
General Pathology for Intraocular Microsurgery Direct Wounds and Indirect Distant Effects
76
Access via Corneal Limbus Fornix and Limbus Based Conjunctival Flaps
86
Pars Plana Transscleral Approaches
90
Minimally Invasive Intraocular Microsurgery
91
Microsurgical Manipulations in the Anterior Chamber Critical Structure and Vulnerable Cell Populations
92
Iris Microanatomy
93
Posterior Lens Capsule and Posterior Zonula Insertion
94
Surgically Induced Necrotizing Scleritis SINS
95
References see also page 379
96
Special Anatomy and Pathology in Intraocular Microsurgery
97
Bowmans Layer
98
Corneal Stroma
100
5115 Endothelial Cells
101
Tear Film
102
Anterior Chamber Associated Immune Deviation ACAID Corneal Immune Privilege Corneal Antiangiogenic Privilege
105
Limbal Epithelial and Corneal Stromal Stem Cells
107
Corneal Innervation
108
Corneal Landmarks Definition of Limbus
109
Corneal Dimensions
110
Ectatic Disorders Keratoconus Keratoglobus Keratotorus
113
Acquired Corneal Pathologies
114
Neurotrophic Keratopathy
116
Trauma
118
Immune Reactions
119
Surgical Procedures
121
Suturing Technique
123
Refractive Surgery and Phototherapeutic Keratectomy
125
Stem Cell Transplantation and Donor Limbal Stem Cell Procurement
126
Epithelial Invasion LASIK Keratoplasty
127
Recurrence of Corneal Dystrophy
128
Glaucoma Surgery
131
Landmarks for Surgical Corneal Limbus
135
Surgical Pathology
136
Open Angle Glaucomas OAG
138
Congenital Open Angle Glaucomas
140
Indications and Contraindications for Microsurgery of Glaucomas
143
Laser Trabeculoplasty
144
Procedures for Acute Secondary Open Angle Glaucomas
145
Filtrating Glaucoma Surgery
146
Concept of a Transtrabecular Shunt Between the Anterior Chamber and Schlemms Canal
148
Contraindication to Filtering Procedures
149
Late Conjunctival Bleb Wound Dehiscence
150
Consequences of Acute and Persistent Ocular Hypotony Following Filtrating Glaucoma Surgery
151
Iris
152
Surgical Anatomy
153
BloodAqueous Barrier
154
Biocytology of Normal Pigmented Cells of the Iris
155
Surgical Pathology
156
Angle Closure Glaucomas Via Pupillary and Ciliary Block
158
Iridodialysis
159
Tumors of the Iris
161
Epithelial Ingrowth Diffuse and Cystic
164
Noninvasive In Vivo Diagnostic Procedures for Processes of the Iris
166
Indications for Surgical Procedures Involving the Iris
169
Mechanical Iridotomy and Iridectomy
170
Mechanical Mydriasis
171
Ciliary Body
176
Surgical Anatomy
178
Lens DecentrationSubluxation and Cataract Formation After Block Excision
216
Lens and Zonular Fibers
217
Basic Aspects of Intraocular Anatomy for Microsurgery of the Lens
219
Features of Lens Epithelial and Fiber Cells
220
Lens Capsule
221
Lens Epithelium
222
Lens Fibers
224
Suspensory Apparatus
225
Wiegers Ligament
226
Lens Capsule Epithelium Fibers and Zonules
227
Biochemical Changes
228
Surgical Pathology of the Lens
229
Lenticonus and Lentiglobus
230
Lens Dislocations Ectopia Lentis
232
Traumatic Luxation
234
Basic Mechanisms of Cataract Formation
236
Basic Aspects of Cataract Surgery
244
Extracapsular Cataract Extraction
245
Intracapsular Cataract Extraction
246
Complications
247
FibrosisType PCO
248
PearlType PCO
249
Soemmerrings Ring
250
Other Causes of PCO
251
True Pseudophakic Accommodation and Pseudoaccommodation
252
Retina and Vitreous
255
Bursa Macularis
256
Horizontal Barriers Leitstrukturen
257
Subretinal Immune Privilege
258
Surgical Pathology
260
Cystic Retinal Tuft
261
Peripheral Microcystoid Degeneration
262
Peripheral Retinal Holes and Tears Fig 566
263
Retinal Detachment
266
Effects of Detachment of the Ocular Tissues
267
Exudative Detachment
268
Traction Detachment
269
Retinoschisis Fig 568
270
XLinked Retinoschisis
272
Macular Hole
273
Vitreoschisis and Both Macular and Peripheral Pucker Figs5619
279
Retinal Vascular Abnormalities and Neovascularization Figs56205627
281
Central Retinal Vein Occlusion
287
Radiation Retinopathy
289
Coats Disease
290
Choroidal Neovascularization Figs 56285632
291
Tumors of Choroid and Retina
294
DyesVitreous Substitutes and Infusion Fluids Fig5635
299
Vitreous Substitutes and Tamponades
300
Infusion Fluids
302
Release of Vitreous Traction
305
Removal of Internal Limiting Membrane
306
Removal of Vitreous Opacities
307
5635 Retinal Hypoxia
310
Choroidal Neovascularization and Atrophy
311
General Concepts in the Treatment of Tumors of Choroid and Retina
312
Wound Healing and Complications of Therapy
314
Active Cell Populations
316
Hyalocytes
317
Endothelial Cells Astrocytes and Vascular Development Fig5637
318
Angle Closure Glaucoma After Vitreoretinal Surgery
319
References
320
Optic Nerve and Elschnigs Scleral Ring
335
Anomalies of the Optic Disc Are Associated with the Discs Size Tables 574 575
337
Surgical Pathology and Indications for Microsurgery
339
Glaucomatous Disc Damage
340
Giant Cell Arteritis and Biopsy of the Temporal Artery
342
Optic Disc in NonIschemic Central Retinal Vein Occlusion and Opticotomy
343
Congenital Pits of the Optic Nerve
344
Vitreoretinal Microsurgery
345
Intracranial Hypertension Acute and Chronic Variants Must Be Distinguished
346
Wound Healing and Complications
347
References see also page 379
348
Influence of Common Generalized Diseases on Intraocular Microsurgery
350
Diabetes Mellitus
351
Risk of Infection
352
Arterial Hypertension and Vis A Tergo
353
Pseudoexfoliation Syndrome Pathological Manifestations of Relevance to Intraocular Surgery
354
Pathobiology of PEX Syndrome
355
Clinical Diagnosis and Early Recognition
357
Masked PEX Syndrome
359
Surgical Pathology
360
Iris
364
Trabecular Meshwork
368
Cornea
371
Microsurgical Considerations
374
Postoperative Complications
375
Other Generalized Diseases
378
General References
379
List of Figures
381
List of Tables
387
Subject Index
391
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