Cataract

The recent agreement between Valeant and Croma-which would provide for the distribution of Croma’s ophthalmology products in Western Europe-is expected to expand Bausch + Lomb’s (B + L) ophthalmic portfolio in the United States.

The European Society of Cataract and Refractive Surgeons (ESCRS) never fails to entice ophthalmology with cutting-edge technology, and the XXXII Congress in London has not disappointed attendees. This year’s congress has displayed a wide range of new technologies from cataract and refractive platforms to diagnostic units to surgical instruments. From all the equipment presented, IOL advances have again captured the attention of attendees.

A novel multifocal IOL with a unique axiconic-like shape changes a ray of light into a focal line and provides patients with an extended depth of focus.

A preloaded IOL system shaved about 1 minute and 2 seconds from each cataract case performed at a single surgical site by reducing preoperative lens-related preparation activities.

The decision on IOL type and fixation method in eyes without adequate capsular support should take into account the specific clinical presentation.

A new method being developed to improve the accuracy of IOL power calculations for cataract surgery uses pattern recognition as its basis.

Kenneth J. Rosenthal, MD, explains the advantages of an add-on sulcus-based IOL for correcting refractive errors in eyes that have undergone cataract surgery with in-the-bag IOL implantation.

A diffractive trifocal IOL is novel technology that delivers good near, intermediate, and far vision and has other advantages.

Researchers in the United Kingdom have demonstrated that advanced DNA testing for congenital cataracts can quickly and accurately diagnose several rare diseases marked by childhood blindness.

The creation of a sufficiently long-internal incision as well as stromal hydration and a moderate final IOP are effective steps to reduce fluid ingress-and lower risk of infection-into the eye following cataract surgery, according to Neal Shorstein, MD.

When consulting with patients who present with decreased vision due to cataracts, ophthalmologists need to remember their role as physicians first, suggest the authors. The primary goal of the office visit is to address the complaint and the solution in entirety before moving into outcomes.

Assessment for wound leaks should be undertaken in a standardized and quantifiable fashion, and alternative means for wound closure, such as an ocular sealant, should be considered.

A silicone ring-shaped device for assisting continuous curvilinear capsulorhexis creation provides a guide for precisely sizing and positioning the capsular opening.

A novel device for pupil dilation offers several advantages over current devices, including the ability to be inserted through smaller sizes and lesser numbers of incisions in procedures, noted its inventor, Suven Bhattacharjee, MS, DO, DNB, FRF.

Leading cataract surgeons speak to recent enhancements to a femtosecond laser and benefits of its integration with an image-guided system.

The FDA has approved Omeros’ phenylephrine and kertorolac injection 1%/0.3% (Omidria) for use during cataract surgery or IOL replacement (ILR) to maintain pupil size by preventing intraoperative miosis and to reduce postoperative pain.

The Infant Aphakia Treatment Study evaluated outcomes after unilateral cataract surgery during early infancy in children randomly assigned to primary aphakic correction with an IOL or contact lens. Visual acuity results and clinical findings during follow-up through age 5 were recently published.

Early treatment of pediatric cataracts is crucial, with proper consideration being given to age and the type of postoperative correction to be used.

Patients needing glaucoma surgery may also be candidates for a combined procedure with cataract removal and IOL implantation. For a variety of reasons, cataract surgery may present challenges in eyes with glaucoma. Alan S. Crandall, MD, provided cases to demonstrate the complexities encountered when performing cataract surgery in glaucoma patients and strategies for achieving successful outcomes.

A new patient interface improved the usability and performance of a femtosecond laser system in a multicenter study.

Due to the extraordinarily high volume and minimal surgeon time, the average cataract cost-including IOL choice-ranges from $41 to $125 at India’s Aravind Eye Hospital, said David W. Hutton.

Substituting generic products for brand name innovators in cataract surgery medication regimens can bring trade-offs in efficacy, safety, and convenience, perhaps with just modest savings in cost.

Based on unknown preoperative anatomic considerations, efficacy, and safety data, phacotrabeculectomy may be a better option than phacoemulsification alone or combined with a microincision glaucoma surgical procedure in eyes with advanced glaucoma needing cataract surgery and low IOP.

Perioperative intracameral antibiotics should be standard practice during cataract surgery to prevent postoperative endophthalmitis.

In a multicenter phase II study of cataract surgery patients, recipients of a dexamethasone-releasing punctum plug (Ocular Therapeutix) were significantly more likely than their vehicle-treated counterparts to be free of pain and anterior chamber cells at various postoperative follow-up visits.

A retrospective analysis including data from a consecutive series of 1575 eyes shows that intravitreal placement of triamcinolone/moxifloxacin during cataract surgery is a safe and effective method for preventing inflammation, endophthalmitis, and cystoid macular edema.

Understanding why ophthalmologists should be using intracameral antibiotics to lower the risk of postoperative endophthalmitis after cataract surgery.

Three-dimensional (3D) visualization and guidance may be the future of lens IOL implantation. Douglas Koch, MD, posed two questions: Can surgeons eliminate marking for toric IOLs and eliminate the oculars on the microscope as well?

Following cataract surgery, patients can present with a variety of visual complaints that interfere with vision after IOL implantation. Negative dysphotopsias are relative and absolute scotomas, according toJack T. Holladay, MD.

Patients have high expectations regarding cataract surgery outcomes, and anything less than perfect may be considered a failure, said Kendall E. Donaldson, MD, MS.