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New ketorolac solution optimized for safety and patient comfortFrom a patient's perspective, using a non-steroidal anti-inflammatory drug (NSAID) before and after cataract or refractive surgery can help to ease pain, swelling, and irritation, and accelerate the return of visual acuity. From a surgeon's perspective, using an NSAID reduces surgical complications and makes surgery easier: it keeps the pupils larger, allowing for quicker and less traumatic procedures. It also prevents cystoid macular edema (CME) and reduces the incidence of striae because it suppresses pain and, therefore, the patient's tendency to squeeze/rub the eyes post-surgery. This article will examine the different classes of NSAIDs, compare their analgesic and anti-inflammatory activity, and determine the potency of different NSAIDs.
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Patients need to become partners in glaucoma careFor the past 25 years, the medical management of glaucoma has become increasingly successful. The medications currently available have superior tolerability and efficacy compared with the most commonly used drugs 20 years ago.
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Wavefront measurement methods discussedThe only constant in the relatively young life of refractive surgery has been change. Even now as our patients reap the rewards of decades of research in the form of customized wavefront ablation, currently unforeseen improvements are inevitable.
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Explore the French Quarter's MystiqueThe joie de vivre that New Orleans exemplifies radiates most from the Vieux Carr?, or the French Quarter. Whether you're looking for great music, mysticism, history and architecture, or art and antiques, a walk through this district offers something for everyone.
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Biologic agents treat ocular inflammatory diseaseEditor's Note: As defined by the FDA, the term "biologics" refers to a wide range of products that includes vaccines, blood and blood components, allergenics, somatic cells, gene therapy, tissues, and recombinant therapeutic proteins, such as monoclonal antibodies and antibody fragments.
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Biologic agents treat ocular inflammatory diseaseEditor's Note: As defined by the FDA, the term "biologics" refers to a wide range of products that includes vaccines, blood and blood components, allergenics, somatic cells, gene therapy, tissues, and recombinant therapeutic proteins, such as monoclonal antibodies and antibody fragments.
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Imaging devices may help with glaucoma detectionNew York-Some imaging devices may help predict which patients will develop glaucoma, but "they will not supplant clinical assessment of the optic disc by a trained observer," said Christopher A. Girkin, MD, MSPH, to attendees of the Glaucoma 2006 meeting here.
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Virginia vines and winesGeoffrey Cooper, MD, FACS, a comprehensive ophthalmologist in solo practice in Richmond, VA, sees his hobby of winemaking as an adventure with three parts: growing grapes, making wine, and marketing the wine.
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Podcast: Modern approaches for the optimal treatment of dry eye disease (Part 4)Bill B. Trattler, MD, Crystal Brimer, OD, Cynthia Matossian, MD, FACS, and Kelly K. Nichols, OD, MPH, PhD, discuss dry eye disease and the various approaches clinicians can take to treat the disease in part 4 of the Viewpoints Podcast.
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Accommodating IOL changes radius of surface curvatureAn accommodating IOL (NuLens, NuLens Ltd.) is one of the most exciting IOL technologies under development and research. This lens differs from single-optic and dual-optic accommodating IOL designs in that it changes its power during accommodative effort not by a movement in IOL optic position, but by a change in the radius of curvature of the optic surface.
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Cataract, glaucoma collision sparks MIGS, other innovationThe 2017 Charles D. Kelman Lecture touched on three main areas-from the teaching of the phaco technique during the early years of phaco to use of phaco in glaucoma patients to the introduction of phaco to surgeons in developing countries.
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Analyzing the visual, non-visual benefits of VLF IOLsDaniel H. Chang, MD, shares data on a recent study involving a new violet light-filtering chromophore in a preclinical computer simulation testing and randomized clinical study.
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Facial anatomy key to optimal use of botulinum toxinBotulinum toxin type A effect is usually seen 2 to 3 days following injection, with maximal effect at approximately 2 weeks. Touch-ups are not recommended until 2 weeks have passed.
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Time to enhance re-treatment of LASIK overcorrectionsThe incidence of overcorrection after LASIK for myopia is low, but the results of re-treatment are variable. Re-treating often results in a shift back to myopia, leaving the patient unhappy. To improve the results of LASIK enhancement surgery, a new formula is warranted. In 1999, Drs. Lindstrom and co-workers noted that laser treatment achieved different effects in eyes with primary versus secondary hyperopia. They attributed this effect to dynamics of wound healing.
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Time to enhance re-treatment of LASIK overcorrectionsThe incidence of overcorrection after LASIK for myopia is low, but the results of re-treatment are variable. Re-treating often results in a shift back to myopia, leaving the patient unhappy. To improve the results of LASIK enhancement surgery, a new formula is warranted. In 1999, Drs. Lindstrom and co-workers noted that laser treatment achieved different effects in eyes with primary versus secondary hyperopia. They attributed this effect to dynamics of wound healing.
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Pioneer of ophthalmic plastic surgery followed his callingEditor's Note: During the time I was a resident at Manhattan Eye, Ear and Throat Hospital (1969-1972), I had the good fortune to work with Byron Capleese Smith, MD. Those who knew him will never forget him, and those who were not able to know him will gain a small glimpse of his persona and his contributions, as written by Christopher Teng, MD. -Norman Medow, MD
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Preserved medications may have detrimental effects in glaucoma patients with concurrent OSDOcular surface disease (OSD) in patients with glaucoma is surprisingly common, yet it remains an under-recognized condition by eye-care specialists. Among patients with severe OSD, approximately two-thirds concurrently are afflicted with glaucoma (range, 42.9% to 88.4%).1 OSD encompasses a myriad of ocular conditions, including keratoconjunctivitis sicca.
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Intracameral entry of antibiotic ointment seen after cataract surgeryA 59-year-old male was referred for decreased vision and glare in his right eye 7 days after uneventful clear corneal (CC) phacoemulsification with IOL implantation. On postoperative day 1, his visual acuity was 20/25 in the affected eye. The anterior chamber reaction revealed 1+ cell and flare and the IOL was clear.
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Not all hypotensive lipids act the same for individualsThe advantages of the hypotensive lipids bimatoprost (Lumigan, Allergan), latanoprost (Xalatan, Pfizer), and travoprost (Travatan, Alcon) over timolol 0.5% (Timoptic, Merck) have been conclusively demonstrated in phase III clinical trials. As a class, these therapies have been shown to reduce IOP and to reduce fluctuations of the diurnal curve significantly. Yet, it is important to understand that despite these commonalities, differences also exist. It is only in understanding these differences, and matching them clinically to the individual profile of the patient, that we can choose the right drug at the right time.
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Where goeth the 110th Congress?Any major changes in health care will reflect the inflluence of moderates on both sides of the aisle.
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In-office versus wholesale labsAs more and more ophthalmologists choose to provide full-service patient care, including eyewear dispensing, the relevant and growing complexities to the choice between an in-office edging lab approach versus an off-site, wholesale finishing lab solution have become increasingly important.
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Pigskins and perception: How neuro-ophthalmology influences NFL refereesEvery football fan knows the scrutiny that NFL game officials are put under every game day, and now a group of ophthalmologists is trying to ensure they can perform at their best each weekend.
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Planning for retirement requires balancing savings, lifestyleIt is extremely important to get a sense of confidence in your planning, because it not only affects your future, but has an impact on your life right now.
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Ophthalmologists called upon to help impaired colleaguesOphthalmologists must take an active role in preventing impaired colleagues from hurting patients, according to Terri Pickering, MD.
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Protecting assets is top priority in malpractice climateRegardless of the state of the malpractice insurance market, physicians always should view asset protection as an important part of their business and personal financial plan. When we use the term "asset protection," we mean shielding personal and practice assets from all potential lawsuits, including malpractice claims.
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Style versus substanceAny asset protection plan that will truly stand up if challenged must have economic substance.
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Family traditionsJames C. Loden, MD, an ophthalmologist in private practice in Nashville, learned much from his father, who also was an ophthalmologist.
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Retinal surgeons might want to consider practicing in ASCFor more than 10 years, it has been inevitable at every meeting that a colleague will nudge me and ask in hushed tones and quivering whispers about performing retina surgery in ambulatory surgery centers (ASCs). It is much like asking for matrimonial advice from Playboy model-turned-actress Anna Nicole Smith, knowing that the advice may be tempting, but somehow immoral and unholy.
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The history of progress and innovation in cataract surgeryInnovations have made procedure quick, safe, effective.
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Star Search-ophthalmology editionSmithtown, NY-The old saw "It's hard to find good help these days" may hold some truth. It's not because solid, qualified, hard-working people aren't looking for jobs. The trick, says James Rienzo, is finding them-and that takes an organized, systematic approach.
