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Cataract

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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.

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.

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.

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.

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.

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?

Identifying, managing dysphotopsia after cataract surgery

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.

This month’s simultaneous meeting of the American Society of Cataract and Refractive Surgery and American Society of Ophthalmic Administrators will convene in Boston from April 25 to 29.