Cheryl Guttman

Irvine, CA-Standard refraction and vision outcome measures were found to be excellent and comparable in eyes undergoing LASIK flap creation with the femtosecond laser (IntraLase FS, IntraLase Corp.) versus with a mechanical microkeratome, but flap construction with the femtosecond laser is associated with less change in ocular aberrations, according to Dan B. Tran, MD.

St. Louis-Epithelial defect risk associated with the Hansatome microkeratome (Bausch & Lomb) is significantly reduced by use of the zero compression head, according to the results of a retrospective study undertaken by Stephen A. Wexler, MD.

Barranquilla, Colombia-The Carriazo-Pendular microkeratome (Schwind Eye-Tech Solutions) is a highly versatile microkeratome that can be used with great safety to produce high-quality flaps for LASIK and perhaps even for LASEK procedures, said Cesar Carriazo, MD.

The Centurion SES EpiEdge epikeratome (CIBA Vision) is a simple instru-ment to use that safely and reliably separates the epithelium from the stroma via mechanical forces to create an intact epithelial sheet in eyes undergoing Epi-LASIK, said Ioannis G. Pallikaris, MD, PhD, who invented Epi-LASIK and participated in the development of the epikeratome.

Chicago-Bleb leaks occur in 2% to 7% of eyes after filtering surgery and are important to recognize and treat because they can be a precursor to other complications, including ocular hypotony, blebitis, and endophthalmitis.

Chennai, India-Phakonit (Phako with a Nee-dle Incision Technology) is a bimanual approach to phacoemulsification performed with a needle opening via an incision and with the phaco tip. The technique drastically reduces incision size, and with the ad-vent of ultra-small incision IOLs, it offers cataract patients the advantages of astigmatism-neutral sur-gery with return to stable vision within 4 to 5 days after surgery, said Amar Agarwal, MD, an innovator of the technique.

Charleston, SC-In an ongoing prospective study, conventional and custom wavefront-guided LASIK have been shown to achieve uncorrected visual acuity (UCVA) outcomes exceeding the FDA grid, but there are dramatic differences favoring the wavefront-guided approach in analyses of treatment effects on higher-order aberrations, said Kerry D. Solomon, MD.

Charleston, SC-Not all Hartmann-Shack-style wavefront aberrometers are the same, according to the interim results of a prospective study presented by Kerry D. Solomon, MD.

Pekin, IL-Results from 6 months of follow-up in the Allegretto Wave (WaveLight Laser Technologie, Erlangen, Germany, and Lumenis) hyperopic LASIK clinical trial demonstrate excellent efficacy, safety, accuracy, and predictability, said William I. Bond, MD.

Hull, England-One researcher hopes to identify presbyopic eyes likely to benefit from an accommodating IOL and target the postoperative refraction in order to optimize the benefit.

Windsor, England-Piggybacking with the low-power meniscus MA60MA IOL (AcrySof, Alcon) is a useful technique for safely and accurately correcting post-cataract surgery ametropia, according to the results of a case series presented by Richard B. Packard, MD.

The Clariflex and Sensar AR40e IOLs (AMO) are physician-friendly implants that provide patients with unsurpassed optical performance because of their proprietary OptiEdge (AMO) design, agree cataract surgeons who favor the OptiEdge IOLs.

Stanford, CA-The phase III trial of the iris-claw phakic IOL (Artisan, Ophtec) for the treatment of hyperopia is now 2 years post- launch, and the short- and long-term results from the interim analyses are very encouraging, said Edward E. Manche, MD.

Madison, WI-The Implantable Contact Lens (ICL, STAAR Surgical) in eyes with moderate to high myopia produced at least comparable outcomes if not better than those achieved after LASIK, said John A. Vukich, MD.

Visual performance after cataract surgery is superior in eyes with the aspheric IOL implanted compared with other commonly used foldable implants, according to the results of a blinded, prospective, randomized study presented by Robert M. Kershner, MD, FACS.

Exciting progress continues to be made in IOL technology. However, as researchers develop new materials and designs, Nick Mamalis, MD, cautioned that care must to be taken to avoid revisiting old problems so that, as the Barenaked Ladies song title says, "Everything Old is New Again."

Editor's Note: The CrystaLens was recommended for approval by the FDA's Ophthalmic Devices Advisory Panel in late May. The lens may be commercially available later this year or early 2004. Dr. Doane's presentation was given at the annual meeting of the American Society of Cataract and Refractive Surgery prior to the recommendation.

Milan, Italy-Combining phakic IOL implantation with LASIK is a very safe and effective strategy for treating eyes with high myopia and astigmatism, according to Francesco Carones, MD.

Mainz, Germany-Refractive lens exchange with implantation of a foldable, multifocal IOL is a safe, effective, and stable surgical option for the treatment of hyperopia and myopia in the presbyopic population.

Washington, DC-If the proposed 2004 Medi-care Fee Schedule goes into effect January 1, ophthalmologists are likely in for more belt-tightening. The 4.2% cut in physician fees called for in this recently published rule may come as no surprise to many in the ophthalmic community. However, the American Academy of Ophthalmology (AAO), American Society of Cataract and Refractive Surgery (ASCRS), and other physician-provider groups are lobbying for provisions to address what they see as a flaw in the sustainable growth rate formula.

Alicante, Spain-Wavefront-oriented LASIK is a safe, effective, and predictable procedure for reducing higher-order aberrations and correcting residual refractive errors present after conventional LASIK, said Jorge L. Alio, MD, PhD.

New York-Decisions on the management of glaucoma associated with arteriovenous (AV) fistulae requires close collaboration with neuroradiologists and other physician colleagues and careful discussion of observation versus intervention, said James C. Tsai, MD.

San Diego-Both conventional LASIK and PRK induce higher-order aberrations to a similar extent, but their effects on individual aberrations are distinctly different, according to Capt. Steve C. Schallhorn, MD.

Los Angeles-A preliminary analysis of results from the Los Angeles Latino Eye Study (LALES) indicates open-angle glaucoma (OAG) has a high prevalence among older Latinos. In addition, the rate exceeds that found in white populations and is at least comparable with that seen among blacks, said Rohit Varma, MD, MPH.

San Francisco-An interim analysis of data from an ongoing European multicenter study of the Phakic Refractive Lens (PRL, CIBA Vision/Medennium) indicates that the posterior chamber implant is a safe, effective, and predictable method for correcting high myopia, said Bo Philipson, MD, PhD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

Houston-Developing a basic understanding of the relationships among wavefront, contrast sensitivity, and Snellen visual acuity and how each describes quality of vision is critical to interpreting studies investigating the efficacy and safety of wavefront-guided refractive surgery, noted Jack T. Holladay, MD, MSEE, FACS.

San Francisco-The integration of refractive error information obtained with a wavefront aberrometer into surgical planning may improve the results of conventional LASIK, said David R. Hardten, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

San Francisco-Intraoperative pachymetry is important in eyes undergoing LASIK because corneal thicknesses measured just before the microkeratome pass differ significantly from values obtained on a preoperative day, and at least when using the Hansatome microkeratome (Bausch & Lomb), correlate significantly with flap thickness, said Michael A. Redmond, MD, at the American Society of Cataract and Refractive Surgery annual meeting.

San Francisco-Wavefront aberrometry is a valuable tool for understanding the etiology of visual complaints post-LASIK in some patients with large pupils and appears to be promising as well for guiding "custom upgrade" procedures to address debilitating symptoms in those cases, said James J. Salz, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

Chicago-As progress continues to be seen in technology for identifying structural and functional glaucomatous changes, ophthalmologists may be wondering whether and how to incorporate those modalities into their practices.