IOL

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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.

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.

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.

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.

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.

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.

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.