Cataract & Refractive

Robert J. Cionni, MD

The AcrySof? ReSTOR? lens is the first apodized diffractive intraocular lens (IOL) to become available, and clinical results with this lens seem to be different from those seen with older technology. We're familiar with previous lens technology, either zonal refractive or full aperture diffractive designs. I will discuss the advantages and disadvantages of these older designs and explain how the new AcrySof? ReSTOR? lens represents a breakthrough technology.

Refractive lens exchange has become the procedure of choice for correcting high ametropia in the presbyopic patient. From the refractive surgeon's perspective, the AcrySof? ReSTOR? lens is a wonderful option for refractive lens exchange. It is safest in eyes without high or excessive axial length. Until recently, the only implants available for refractive lens exchange were monofocal intraocular lenses (IOLs). These provided patients with a single focal point, either for reading or for distance. The Array? multifocal IOL became available several years ago, but my experience, and the collective experience of many other surgeons, was that this zonal refractive, multifocal IOL did not provide a satisfactory result for most patients.

Robert J. Cionni, MD

With lengthening follow-up, the posterior chamber ICL (STAAR Surgical) continues to be associated with encouraging results in the management of refractive amblyopia in children who have failed conventional therapy with contact lenses or spectacles, said Laurence C. Lesueur, MD.

Approved by the FDA in March 2005 for use in cataract patients with or without presbyopia, Alcon's AcrySof ReSTOR lens is the first apodized diffractive intraocular lens (IOL) to be made available. The approval was granted based on clinical trials which found that patients experienced the highest level of freedom from glasses ever achieved in IOL clinical trials.

Major advances have been made in the understanding of the pathogenesis of posterior capsule opacification (PCO) post-cataract surgery, and improvements in surgical technique and lens biocompatibility and design have reduced the rates of opacification in recent years. Nonetheless, opacification remains an important complication in patients undergoing phacoemulsification or extracapsular cataract extraction combined with intraocular lens (IOL) placement, with approximately up to 25% of patients developing visually significant PCO during the first five years post surgery.

Epi-LASIK combines the advantages of both LASEK and LASIK while minimizing the disadvantages of each

The fundamental issue of wound integrity has dissuaded me from pursuing further research and development of this technique

The formation of Elschnig pearls is a highly dynamic process and is detectable even over very short time intervals. Elschnig pearls can appear or disappear within one day, according to Oliver Findl, MD, from the Medical University of Vienna, Austria.