Cataract surgery is the most common surgery in ophthalmology. The aim of cataract surgery is to restore vision in eyes in which the natural lens became opacified mostly due to the aging of the lens, or the presence of other ocular diseases, which promote earlier cataract formation. During cataract surgery, artificial intraocular lens (IOL) is implanted into the lens capsule and the value of the IOL is planned before surgery based on the preoperative IOL calculation. However, in the significant number of patients, cataract surgery may end up with a postoperative refractive error in which case patients have to wear glasses to reach the full vision for both distance and near correction (if monofocal IOL is used during cataract surgery!). Modern cataract surgery becomes more and more a refractive procedure as well, especially when multifocal and/or toric IOLs are implanted. However, in some specific cases where such IOLs are not applicable, high postoperative refractive error after cataract surgery can significantly influence the quality of the obtained vision. One such example is cataract surgery after penetrating keratoplasty. In this chapter, results of a novel approach of post-PK ametropia correction, namely implantation of sulcus placed AddOn IOLs (also called a piggyback lens) will be presented.
Limbal epithelial stem cell (LSC) deficiency is severe disease of the anterior eye surface, causing corneal opacification and significant vision loss in the affected patients. Treatment of such patients by corneal graft is ineffective due to the fact that corneal donor tissue cannot survive in the eye without LSC. One of possible treatment options is to provide LSC from the other, unaffected eye, and to perform corneal graft later on, as a second procedure. In this paper, we have evaluated the visual outcome and clinical improvement in three eyes receiving ex vivo cultivated limbal epithelial stem cell graft to treat their limbal stem cell deficiency (LSCD) caused by corneal burn. We aimed at determining whether this treatment alone might provide sufficient visual improvement to avoid corneal grafting as a second surgery.
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