Visual Impairment Caused by Monovision Surgical Design

Neurophysiological anatomy of natural binocular vision shows the need to focus with both eyes to jointly produce the two corneas accommodation, correcting, in a compensatory way, the divergences inherent in the two different images, of the same visual field projected in the two distinct spaces, the two retinas. Corneal accommodation is part of the forced convection mechanism for the transfer of mobile mass in the cornea, trabecular meshwork and retina, to inhibit the accumulation of dehydrated intraocular metabolic residue, which can cause refractive errors in the cornea, obstruction of the trabecular meshwork and reduction of the amplitude of the signals produced by the phototransducers and sent to the brain. The IOL monovision surgical implantation technique differs from the physiology of natural binocular vision, which can cause after surgery disorders, described in this chapter, in that it imposes a different adaptation from the neurophysiological anatomy of human vision in addition to favoring the continuous progression of residue accumulation dehydrated intraocular metabolic and stimulate ocular.

Cataract Surgery in Post-Vitrectomized Eyes

Because of the application of vitreoretinal surgical techniques to a broader range of posterior segment diseases and because cataract develops frequently in postvitrectomy eyes, cataract surgeons should be familiar with the challenges of cataract extraction in vitrectomized eyes. Cataract surgery after pars plana vitrectomy significantly improves visual acuity in 85% of cases, limited by retinal comorbidity and surgical complications. However, despite recent advances, this surgery remains a special challenge. The cataract surgeon can prepare for these challenges with awareness of such potential factors as an excessively mobile posterior capsule, silicon oil removal and special considerations concerning intraocular lens selection and power calculation. And consider the postoperative complications as posterior capsule opacification or refractive errors.