Cataract

The most recent analyses of data from the ARMOR (Antibiotic Resistance Monitoring in Ocular micRoorganisms) Surveillance Program can guide clinicians choosing antibiotic therapy for initial empiric therapy and infection prophylaxis. The information also reinforces the importance of prudent antibiotic prescribing to limit the development of bacterial resistance to existing options, according to Penny Asbell, MD.

Though extended depth-of-focus lenses tend to be more forgiving of residual refractive error and mild decentration than other presbyopia-correcting IOLs, it is important to select patients carefully and follow good preoperative protocols for a successful outcome.

Surgeons should use a centroid value for surgically induced astigmatism rather than a mean or median value when working with toric IOL calculators.

Cataract and refractive surgeons should use prophylaxis to avoid reactivation of the herpes simplex virus (HSV) in patients with a history of infection with this virus, according to Elizabeth Yeu, MD.

Having explored the various options available for micro-invasive glaucoma surgery (MIGS), I now use several devices with success. One MIGS device (XEN Gel Stent, Allergan) differs from the others in that it drains aqueous into the subconjunctival space and can be performed as a stand-alone procedure without cataract surgery or combined with cataract surgery.

Researchers conducted a 6-month study of patients implanted with the AcrySof IQ PanOptix presbyopia-correcting IOL to determine the binocular defocus curve of the lens. They concluded that these early results show good visual performance across the whole range of defocus. No unexpected adverse events were reported

In the past year, Matossian Eye Associates added a new category of presbyopia-correcting IOLs to the practice: the extended depth of focus (EDOF) IOL. The first IOL in this category is the Tecnis Symfony (Johnson & Johnson Vision). EDOF lenses from other manufacturers are in clinical trials, so it behooves the cataract surgeon to better understand how these lenses work.

Ophthalmology Times asked readers for insights on antibiotics and eye infections from clinicians in the field - including experience with postoperative infections after eye surgery, if you use topical antibiotic prior to cataract surgery, how you choose antibiotics in a routine surgical prophylaxis, and more. The 118 U.S.-based ophthalmologists who responded were entered into a drawing to win a $200 gift card. Here are the survey results.

Findings in the journal Clinical Ophthalmology report that using the technique phacoemulsification was performed without complications in 607 of 609 cataract eyes.

Patients with a contact lens lost in the eye are not a rare occurrence for ophthalmologists. However, 27 lenses at the same time may be another story! Another ophthalmologist shares his experience with a case involving 5 lenses within a patient's eye.

When dealing with patients with retinal disease, macular disease, or a meaningful risk of retinal detachment, certain types of IOLs should be avoided due to potential complications.

Presbyopia patients have changed. They are younger than ever, more active than ever before, and they have more treatment options than ever before.

Fifty years after the idea for phacoemulsification came to Charles Kelman, MD, few would have predicted that surgical platforms would evolve to where they are today.

As the ophthalmic community celebrates 50 years of phacoemulsification (phaco) innovation, surgeons and industry alike mark its progress since the inspiration for the procedure came to Charles Kelman, MD, after a visit to the dentist.

A disposable device for automated anterior capsulotomy that uses precision pulse technology (Zepto, Mynosys Cellular Devices) demonstrated excellent performance in a series of 38 eyes.

Wisconsin ophthalmologist Gerald P. Clarke, MD, has developed a new horseshoe-shaped dilator for use during cases of intraoperative floppy iris syndrome.

A new silicone phacoemulsification sleeve (Ridged Sleeve, ASICO) designed with a variety of novel features is enabling safe and efficient microcoaxial cataract surgery, said Takayuki Akahoshi, MD.

Cataract surgery in eyes undergoing simultaneous endothelial keratoplasty requires several modifications in techniques.

Preloaded IOL systems can save almost 30 seconds of operating time in cataract surgery, according to Damien Goldberg, MD, who participated in a trial with a preloaded delivery system (AcrySof IQ IOL Model AU00TO with UltraSert, Alcon Laboratories).

Los Angeles ophthalmologist Mitchell Shultz, MD, shares some of his clinical experience with a next-generation phacoemulsification platform (Stellaris Elite, Bausch + Lomb). The new platform received 510(k) clearance from the FDA in April.

As the most common procedure performed by the ophthalmic surgeon, in 2014, 4.3 million cataract operations took place in the European Union Member States. It is estimated that more than 23 million procedures will be performed worldwide in 2016.

Implantation of a sulcus-supported, pseudophakic supplementary intraocular lens (IOL) can be a safe and effective method for improving vision in eyes with residual refractive error after cataract extraction, refractive lens exchange, or keratoplasty, said Thomas Kohnen, MD, PhD. It also can be used to provide reversible presbyopia correction.

The most common complication associated with the explantation of foldable intraocular lenses (IOLs) is lens dislocation or decentration. While glare and visual aberrations are the most common reasons for explanting multifocal lenses.

Staging patients based on their ocular pathologies using the most advanced diagnostic tools can result in excellent image quality by precisely establishing the need for lens- or corneal-based procedures.

Posterior chamber phakic IOLs can correct refractive errors associated with keratoconus and can also be combined with other surgical techniques when necessary, according to researchers.

Cataract surgery in patients with coexisting uveitis is more challenging than managing either condition alone. Surgeons must answer a different set of questions and consider alternative management strategies, said Debra A. Goldstein, MD, FRSC, professor of ophthalmology and director of the Uveitis Service, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago.

There are a number of ways to improve near vision for presbyopes, including multifocal intraocular lenses (IOLs)–traditional or low add–and pseudoaccommodative IOLs. It has been well documented that a small pupil and higher order aberrations, such as spherical aberration (SA) or coma, can increase depth of focus.

Increased procedure volume and patient expectations have made IOL exchange procedures more common. Smaller incisions and the need to reduce trauma require new micro-instrumentation for best outcomes.

Though further study is needed to determine conclusively whether or not femtosecond laser-assisted cataract surgery (FLACS) is associated with better refractive outcomes compared with conventional manual surgery, FLACS offers many other benefits that justify its use, according to Robert J. Cionni, MD.

Femtosecond laser-assisted cataract surgery (FLACS) offers some advantages compared with a conventional manual procedure, particularly for certain patients. Currently, however, FLACS does not result in superior outcomes and it has drawbacks that outweigh its benefits, according to Rosa Braga-Mele, MD.