Urology

Las Vegas-Ophthalmologists can use one of several modified strategies to perform cataract surgery in patients who are taking or have taken tamsulosin (Flomax, Boehringer Ingelheim Pharmaceuticals), with good outcomes and low complication rates, when they know of the medication history in advance, David F. Chang, MD, told those attending the annual meeting of the American Academy of Ophthalmology here.

Las Vegas-Ophthalmologists can use one of several modified strategies to perform cataract surgery in patients who are taking or have taken tamsulosin (Flomax, Boehringer Ingelheim Pharmaceuticals), with good outcomes and low complication rates, when they know of the medication history in advance, David F. Chang, MD, told those attending the annual meeting of the American Academy of Ophthalmology here.

Orlando, FL-The Optical Laboratories Association (OLA) recently presented its OLA Awards of Excellence, one of the most prestigious awards offered by the optical industry, during The OLA 2006 annual conference, Nov. 9 to 11 at the Gaylord Palms Resort and Convention Center in Orlando.

The year 2006 may be characterized as an interesting one in cataract surgery, according to ophthalmologists who are opinion leaders in the field.

Lexington, KY-Animal studies point to two components of drusen as the driving force for the neovascularization that causes age-related macular degeneration (AMD) -a discovery that opens the way to early detection and drug therapy to prevent the condition, said Jayakrishna Ambati, MD.

Several options are available to cataract surgeons to manage anticipated IFIS. In the multicenter prospective trial, surgeons could use a mechanical restraining device (iris expansion ring or iris retractors) to enlarge the pupil and keep the iris from prolapsing, viscodilation with Healon 5 (Advanced Medical Optics), or pharmacologic intervention with atropine administered three times daily beginning 2 days before surgery.

The American Society of Cataract and Refractive Surgery (ASCRS), the American Academy of Ophthalmology (AAO), and the American Urological Association (AUA) have joined forces to launch a patient and prescriber education campaign about the risk of intraoperative floppy iris syndrome (IFIS) associated with the current or previous use of an alpha-1 blocker and the likelihood of successful surgery if the ophthalmologist is aware of that medication history and is able to employ appropriate surgical strategies.

The American Society of Cataract and Refractive Surgery (ASCRS), American Academy of Ophthalmology, and American Urological Association all encouraged cataract patients to talk about medications, mainly alpha-blockers, used for benign prostatic hyperplasia and certain types of lower urinary tract symptoms before undergoing cataract surgery.

New York-The Ex-PRESS glaucoma implant (Optonol) is a device that may be coming into its own, at least for some selected patients undergoing glaucoma surgery, Robert D. Fechtner, MD, reported at the Glaucoma 2006 meeting here.

New York-A gold micro-shunt (GMS, SOLX) implant holds promise for reducing complications of trabeculectomy by lowering IOP, said Celso Tello, MD.

Salt Lake City-Population studies in Utah and Iceland have identified a gene variant that is associated with an increased risk of a precursor of age-related macular degeneration (AMD), researchers report.

The theoretical benefits of laser iridotomy are that it can relieve reverse pupillary block, alter iris configuration, reduce pigment release, and improve long-term IOP control.

San Francisco-DisCoVisc (Alcon Laboratories) performs better than Healon 5 (Advanced Medical Optics) during cataract surgery in patients who have been taking tamsulosin HCl (Flomax, Boehringer Ingelheim), which is a culprit in the intraoperative floppy iris syndrome (IFIS), according to Satish Modi, MD, FRCS (C).

San Francisco-Questioning patients before cataract surgery about whether they are taking alpha-1 blockers, such as tamsulosin (Flomax, Boehringer Ingelheim), has become increasingly important in light of the observation by David F. Chang, MD, and John R. Campbell, MD, that the drug, which is used to treat the symptoms of benign prostatic hyperplasia, can cause intraoperative floppy iris syndrome (IFIS).

For almost 2 years, I have pioneered a change in phaco needleconfiguration to improve the safety of cataract surgery. The DeweyRadius Tip, manufactured by Microsurgical Technologies (MST,Redmond, WA) is a standard phaco needle with a simpleexception-no sharp edges. This rounded design can be appliedto any phaco needle of standard gauge, bevel, or bend.

Baltimore?A trial program that provided support and advice to older nursing home residents with poor vision improved their access to cataract surgery substantially. But the debilitated condition of many of those residents led to hesitation about surgery not only from physicians looking after the older people but also from their guardians, according to ophthalmologists at the Johns Hopkins University's Wilmer Eye Institute, Baltimore.

It might be wise to counsel patients regarding the possible but likely low risk of NAION, especially for individuals with a higher risk for NAION.

Proper management of cataract cases involving intraoperative floppy iris syndrome (IFIS) should keep surgeons from experiencing complications associated with the problem, reported Alan Crandall, MD, at the World Ophthalmology Congress on Thursday.

Cincinnati—Tamsulosin HCl (Flomax, Boehringer Ingelheim), an alpha-1 blocker used to treat benign prostatic hyperplasia, has been implicated in the development of floppy iris syndrome during cataract surgery, according to Robert H. Osher, MD. Healon 5 (AMO) is his viscoadaptive agent (OVD) of choice to manage this challenging iris behavior during cataract surgery.

Chicago—Insertion of the Perfect Pupil Injectable (PPI, Milvella Pty. Ltd.) is an effective method for protecting the iris and maintaining a large pupil during cataract surgery in eyes predisposed to intraoperative floppy iris syndrome (IFIS), according to the results of an interventional case series reported at the annual meeting of the American Academy of Ophthalmology.

Cincinnati—Tamsulosin HCl (Flomax, Boehringer Ingelheim), an alpha-1 blocker used to treat benign prostatic hyperplasia, has been implicated in the development of floppy iris syndrome during cataract surgery, according to Robert H. Osher, MD. Healon 5 (AMO) is his viscoadaptive agent (OVD) of choice to manage this challenging iris behavior during cataract surgery.

Industrial robots—computer-controlled machines that lift, place, move, or perform specific tasks—have been performing repetitive and even dangerous jobs for several decades. Examples of such machines are found in automobile production lines, spraying paints, transporting assemblies between workstations, and welding frames and bodies with great speed, accuracy, and repeatability.

Cincinnati—Robert H. Osher, MD, professor of ophthalmology at the University of Cincinnati and medical director emeritus of the Cincinnati Eye Institute, is celebrating 20 years of the Video Journal of Cataract and Refractive Surgery with two issues in 2006.

Chicago—This past October, the FDA issued a labeling change for the drug tamsulosin HCl (Flomax, Boehringer Ingelheim) warning of the possibility of intraoperative floppy iris syndrome (IFIS), stating "The patient's ophthalmologist should be prepared for possible modifications to their surgical technique."

Paradise, CA—Fashion Optical Displays has named Ed Muehlberger vice president of sales and development. In the new position, Muehlberger will coordinate the company's domestic and international sales, its design staff, and its plans for corporate expansion.

Intraoperative floppy iris syndrome (IFIS) can result in a high complication rate when unanticipated, but with a simple preoperative medication history, cataract surgeons can now predict when this problem may occur, said David F. Chang, MD, in the ?Spotlight on Cataract Surgery 2005? session held during the annual meeting of the American Academy of Ophthalmology.

Editor's Note: Howard Pomeranz, MD, describes a possible association of sildenafil and non-arteritic anterior ischemic optic neuropathy (NAION). There are several compelling parts of the argument, including temporal relationship of symptoms to drug delivery, a suggestive rechallenge history, a biologically plausible mechanism of effect, and analogy from other cases.

Dorado Beach, Puerto Rico—Newer techniques for managing the small pupil are effective, thus enabling safer phacoemulsification. Stephen Obstbaum, MD, reviewed the techniques that are available and demonstrated their use at the Current Concepts in Ophthalmology meeting.

Washington, DC &#8212 With the recent acquisition of VISX and last month's FDA approval of its ReZoom multifocal refractive lens, Advanced Medical Optics (AMO) appears to be experiencing "some exciting times" in ophthalmology.

When I was a boy, my father mentioned several times how he might have purchased IBM stock decades earlier, and how much such an investment would have been worth at the time. Often, people tell me how they refrained from purchasing a waterfront home because the price seemed way too steep, only to have the value subsequently shoot up 10-fold. Perhaps we all regret not making certain purchases long ago.