Surgery

As the end of 2003 approaches, it is estimated that nearly 100 million people around the globe wear contact lenses. This translates into approximately 4% to 5% of all spectacle wearers. Quite a large marketplace.

Antwerp, Belgium-Patients who have received the CrystaLens AT-45 accommodating IOL (eyeonics, formerly C&C Vision, Aliso Viejo, CA) after cataract extraction achieve very good distance and intermediate vision as well as improvements in their near vision, according to Erik L. Mertens, MD, FEBO, director and ophthalmic surgeon at Antwerp Eye Center, Antwerp, Belgium.

Developments in refractive surgery are interdependent and encompass diagnostics, surgical technology, and supportive therapeutics, all of which have a common goal: emmetropia. A number of advances have grabbed the attention of refractive surgeons over the past year, such as improvements in lasers, materials, and refinements in indications for certain refractive procedures. Wavefront technology is still taking center stage.

Munich, Germany-The aspheric Z9000 IOL (Tecnis, Pfizer) is associated with better mesopic contrast sensitivity relative to conventional IOLs, but does not maintain its superiority to spherical implants when testing is performed under mesopic conditions with glare, said Mike P. Holzer, MD, at the European Society of Cataract and Refractive Surgeons annual meeting.

Leaders in cataract surgery agree the past year has been a time of significant developments in both technique and technology.

Parma, Italy-YAG laser iridotomy has a protective effect in patients with pigment dispersion syndrome (PDS) who are at high risk of developing pigmentary glaucoma, according to the results of a 10-year follow-up study from the Institute of Ophthalmology in Parma, Italy.

Bethesda, MD- Ten patients with late-stage retinitis pigmentosa (RP) will be the first humans to receive intraocular, polymer implants containing genetically modified human retinal epithelial cells that researchers hope will prevent further vision loss.

Refractive lens exchange is a safe and effective procedure for providing multifocal vision, and will ultimately become the treatment of choice for presbyopia, said Stephen F. Brint, MD.

The Terry-Schanzlin Astigmatome System with vacuum speculum (Oasis Medical Inc.) is a disposable microsurgical cutting instrument designed to make uniform and controlled paralimbal incisions that are often used in combination with cataract and lens implant pro-cedures to reduce astigmatism.

The incidence of overcorrection after LASIK for myopia is low, but the results of re-treatment are variable. Re-treating often results in a shift back to myopia, leaving the patient unhappy. To improve the results of LASIK enhancement surgery, a new formula is warranted. In 1999, Drs. Lindstrom and co-workers noted that laser treatment achieved different effects in eyes with primary versus secondary hyperopia. They attributed this effect to dynamics of wound healing.

El Paso, TX-Laser presbyopia reversal (LAPR) is showing promise in the treatment of presbyopia in early clinical trials, according to Bobby Maddox, MD.

Detroit-Ptose-Up (FCI Ophthalmics Inc.) is a viable alternative to traditional sling materials for ptosis repair. Ease of use, durability, and low complication rates are just some of the benefits of this new material.

Although patients with uveitis are at increased risk of complications following cataract surgery with IOL implantation, due to pre-existing inflam- mation, improvements in technology, materials, and surgical techniques have greatly improved outcomes.

Stanford, CA-Tube shunt surgery is an efficacious way to lower IOP in complicated glaucomas, according to Mary Ann Lloyd, MD.

Dallas-The future just became brighter for the nearly 100 million people worldwide who wear contact lenses.

Groningen, The Netherlands-Early preclinical studies are yielding promise that an injected, artificial, capsule-filling lens may offer a possible solution for restoring accommodative ability lost in presbyopia or pseudophakia.

Nuremberg, Germany-The Acri.Smart 48S IOL implanted with the Acri.Glide/Acri.Shooter system (Acri.Tec, Berlin, Germany) enables cataract surgery to be performed completely with the benefits of ultra-small-incision techniques, said Wolfram Wehner, MD.

Atlanta-The FDA is allowing CIBA Vision to tell consumers they may use AOSEPT Clear Care and SOLO-care Plus with silicone hydrogel contact lenses. Clear Care is the first and only no-rub, peroxide-based formula in the United States to receive clearance for this indication.

Dallas-Refocus Group Inc. has received approval to market its PresVIEW scleral incision system in the European Union.

Memphis, TN-EagleVision will manufacture and sell the human and animal glaucoma valves developed by Hood Laboratories.

Hradec Kralove, Czech Republic-The MemoryLens (CIBA Vision), a pre-rolled IOL, provides patients with very good postoperative outcomes and a low rate of posterior capsule opacification (PCO).

London-Exposure of the retina to excessive blue light is hazardous to the pigment epithelial cells and may underlie the increase in the prevalence of age-related macular degeneration (AMD) in individuals in the eighth and ninth decades of life.

The Clariflex and Sensar AR40e IOLs (AMO) are physician-friendly implants that provide patients with unsurpassed optical performance because of their proprietary OptiEdge (AMO) design, agree cataract surgeons who favor the OptiEdge IOLs.

Visual performance after cataract surgery is superior in eyes with the aspheric IOL implanted compared with other commonly used foldable implants, according to the results of a blinded, prospective, randomized study presented by Robert M. Kershner, MD, FACS.

Exciting progress continues to be made in IOL technology. However, as researchers develop new materials and designs, Nick Mamalis, MD, cautioned that care must to be taken to avoid revisiting old problems so that, as the Barenaked Ladies song title says, "Everything Old is New Again."