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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.

Thorough treatment of the ciliary processes-combined with measures for minimizing postoperative IOP spikes and inflammation-will lead to improved outcomes when performing endoscopic cyclophotocoagulation with cataract surgery.

Warming up to ICE

The combination of two microinvasive glaucoma surgeries with cataract surgery may address a patient’s cataract and glaucoma in one procedure.

In a randomly assigned study, including 487 eyes with a leaking clear corneal incision after cataract surgery, closure with a hydrogel sealant was significantly more effective than suturing for preventing fluid egress and was associated with significantly fewer adverse events.

With femtosecond laser lens pretreatment and optimization of the surgical approach, removal of even dense cataracts (LOCS III grade 4) can now be completed without any ultrasound in nearly all cases.

An investigational modular IOL was designed to improve surgeons’ ability to select the right optic the first time, enable safe and easy postoperative enhancement when required, and minimize posterior capsule opacification. A multicenter clinical trial evaluating the IOL was launched in October.

Throughout 2013, there were several studies done that showed various new technologies and advancements have not only shown better refractive outcomes in cataract surgery, but could continue benefiting the outcomes in the future.

While US cataract surgeons still have limited access to pseudophakic correction technology, there were several premium IOLs made available this year that offer toric correction, an important step forward.

When mild glaucoma and a visually significant cataract are both present, the risk/benefit calculus now seems to fall on the side of doing phaco, or a phaco-plus procedure, said James D. Brandt, MD.

The Y-fixation technique is a method of sutureless IOL intrascleral fixation that requires less complicated manipulations and results in better closure than alternatives of its type.

Advances in intraoperative aberrometry are increasing the likelihood that, in the near future, ophthalmologists will be able to achieve emmetropia for all patients undergoing cataract surgery.