IOL

Were he alive today, he would likely feel heartened by how his work has been carried on by Gerd U. Auffarth, MD, FEBO, who is now director of The David J Apple International Laboratory for Ocular Pathology at the University of Heidelberg, Germany.

The 2015 International Society of Refractive Surgery survey, the twentieth such survey and the seventh year published online, presents new findings about surgeons’ preferences in corneal and lens-based surgeries, premium intraocular lenses (IOLs), and femtosecond cataract surgery.

The glued IOL technique introduced by Amar Agarwal, MD, is an effective method for repositioning a dislocated 3-piece IOL in eyes without adequate capsular support, and it has advantages compared with suturing, according to Eric D. Donnenfeld, MD, founding partner, Ophthalmic Consultants of Long Island and Connecticut, Garden City, NY.

While 2015 may not have been the year for ground-breaking introductions or trials in the field of refractive surgery, plenty of improvements have kept the procedure an evolving process, Ophthalmology Times editorial advisory board members said.

A new non-apodized diffractive trifocal IOL allows 88% energy utilization and sends energy to near (40 cm), a preferred intermediate distance (60 cm), and far (infinity). Early results for visual acuity, contrast sensitivity, and photopic symptoms are encouraging.

Implantation of a silicone oil-filled accommodating IOL (FluidVision, PowerVision) provides 3 to 4 D of accommodation along with excellent distance, intermediate, and near vision-all of which remain stable during follow-up to 2 years, said Louis D. Nichamin, MD.

Take-home message: A novel approach to scleral suture fixation of a rotated in-the-bag toric IOL stabilizes the implant at the desired axis and prevents rotation in both clockwise and counterclockwise directions.

Intraoperative aberrometry aphakic and pseudophakic readings can be comparable with careful control of surgical variables. Both readings can be useful to predict postoperative manifest refraction.

This article presents recent epidemiological findings outlining the association between cataract surgery, potential visual acuity gains, glaucoma and the risk of undergoing additional general anaesthesia in under 2s. The authors of the original study concluded that use of IOLs in cataract surgery in young children should be critically reassessed, particularly in settings/communities where close, long-term follow-up is challenging.

In this month's Clinical Round Up, Sharon Freedman, MD, discusses results of the Infant Aphasia Treatment Study, and how it found there is no glaucoma protection from primary IOL placement in children. Additionally, Barbara Parolini, MD, discusses the new hope for better myopic traction maculopathy outcomes.

In what is believed to be the largest reported series of spontaneous in-the-bag IOL dislocation, investigators analyze presenting characteristics and outcomes for 21 eyes with a capsular tension ring (CTR) and 84 eyes without one.

Dr Thomassen shares his personal experiences with the MFR2 IOL, including reasons why the MFR2 is his lens of preference, clinical findings from a real-life setting and considerations for future use.

Careful preparation that includes planning ahead and going into surgery armed with the proper equipment and alternative strategies will facilitate easy and atraumatic explantation when performing IOL exchange, said Stephen S. Lane, MD.

Gifted surgeon, innovator, teacher, humanitarian, and life changer. These are the words used to described Robert Sinskey, MD, by some of his closest ophthalmic colleagues.

In this article, Dr Johannson presents intraindividual IOL comparison follow-up results. Although similar levels of PCO development were observed for both AcrySof and Tecnis one-piece IOLs, fewer glistenings appeared in the Tecnis material, 3 years after implantation.

This follow-up study found anterior capsule opacification development and anterior capsule retraction to be more frequent 3 years after cataract surgery when an IOL with interrupted sharp optic edge at the optic–haptic junction is implanted, compared with an IOL with a continuous edge.

Fluid-based accommodating IOL technology achieved “true accommodation” in a pilot study. A multicenter study of the lens is ongoing.

Multifocal IOLs with a trifocal diffractive optic design are available outside of the United States. They provide good visual acuity for distance, intermediate, and near and appear to provide slightly better intermediate vision than bifocal diffractive multifocal IOLs.

A warm viscoelastic technique aids in the intraoperative delivery and unfolding of a hydrophobic acrylic IOL during cataract surgery.

Modifications to a reusable injector system have reduced resistance between the plunger tip and the IOL, creating a smoother delivery of the lens into the eye.

An optometrist in British Columbia has developed an IOL that his company’s website says “is capable of restoring quality vision at all distances, without glasses, contact lenses or corneal refractive procedures, and without the vision problems that have plagued current accommodative and multifocal [IOL] designs.”

A new epidescemetic keratoprosthesis implanted without total corneal trephination, is a viable alternative to corneal transplantation, according to researchers from Spain, Egypt, and Kuwait reporting in the British Journal of Ophthalmology.

Different corneal diseases present different challenges to achieving the desired refractive outcome after cataract surgery. Cornea specialist Dasa V. Gangadhar, MD, highlights measures to consider in various situations.

The unique properties of a light-adjustable lens are designed to provide predictable results and customized refractive treatments.

Despite the advent of advanced technologies-such as corneal stromal collagen crosslinking (CXL), intracorneal ring segments (ICRS), toric phakic and pseudophakic IOLs, and keratoplasty-patients with keratoconus are mostly being managed with spectacles and/or contact lenses.

Implant exchange in multifocal IOL recipients unhappy with their vision is better performed sooner rather than later. It is even better to avoid the exchange whenever possible by identifying and addressing a treatable cause for the patient’s complaints.The best strategy of all is to prevent dissatisfaction in the first place by attention to patient selection and preoperative management, said Stephen G. Slade, MD.

In his debut blog, Dr. Packer writes of a cautionary tale to physicians when stuck between the wants and needs of married patients.

Highly variable myopia shifts can occur in pseudophakic children. IOL exchange seems to be an acceptable option for treating the high myopia that can develop with lens implantation in children.However, the use of IOLs in growing eyes remains controversial, and outcomes are uncertain because of lack of data, according to Courtney Kraus, MD.

A foldable, hydrophobic acrylic IOL embedded with a small-aperture mask provided excellent visual acuity across all distances in patients who underwent monocular implantation after cataract surgery and was not associated with any visual symptoms that may occur with other presbyopia-correcting IOLs.

With a wide array of IOL options available to their foreign colleagues, U.S. ophthalmologists eagerly await the approval and availability of additional lenses.