News

Elevated IOP accelerates retinal nerve fiber layer (RNFL) loss and increases the risk that glaucoma will progress, according to an observational cohort study of 204 patients recruited from the Diagnostic Innovations in Glaucoma Study.

The upheaval in our current economy is changing the ground rules for skillful handling of personal finances. Some of the time-honored methods for building and maintaining a secure financial future for you and your family need to be modified while today's unpredictable financial crisis runs its course. Here are seven tips from the experts that will help you to come out on top once the financial storm has abated.

Results of a study using a non-contact applanation tonometer (Ocular Response Analyzer, Reichert) to evaluate keratoconic eyes during and after corneal collagen crosslinking demonstrate changes in tonometer measurements that are consistent with changes in corneal thickness, hydration, and regularity.

A 26-year-old African American female presented to the Bascom Palmer Eye Institute emergency room with complaints of progressively decreasing vision in both eyes over the past 2 weeks associated with numbness on the right side of her face and mouth. She also had symptoms of light sensitivity but denied flashes, floaters, or other ocular symptoms. She denied any other recent illnesses, drug usage, exposure to parasites, infections, or risk factors for HIV.

The clinical exam remains the key to ophthalmologists' decision-making related to the diagnosis and determination of progression of glaucoma. "Baseline" technology in ophthalmology practices includes the slit lamp, some lenses, a gonio prism, an automated perimeter, a pachymeter, and optic nerve imaging capability. Other technology, however-such as confocal scanning laser ophthalmoscopy; nerve fiber layer imaging devices capable of scanning laser polarimetry and optical coherence tomography (OCT); and some anterior segment imaging technologies, including ultrasound biomicroscopy and anterior segment OCT-do not yet have absolute sensitivity and specificity and serve as aids to, not replacements for, the ophthalmologist.

Data analyzed from a total of 568 eyes included in a prospective study of Descemet's stripping automated endothelial keratoplasty indicate that the time from donor death to surgery affects endothelial cell density loss and risk of graft dislocation, but more data are needed to understand possible associations better.

The most common adjusting error that opticians make is temples fitted too close to the patient's head. When this mistake and others are seen it means that somewhere an optician has been improperly trained and is making the mistake on a daily basis.

Evaluation of corneal topography and the ocular wavefront are critical in screening and treating refractive surgery candidates. The diagnostic tools needed to perform these assessments continue to improve.

A proprietary high-resolution spectral-domain optical coherence tomograph (Spectralis, Heidelberg Engineering) offers many advantages to clinicians, such as superior image quality, true multimodal imaging, and improved monitoring of disease progression, says one doctor.

Luxottica Group is carrying out a number of cost-cutting measures, including store closings, manufacturing reductions, and cuts in advertising. These changes came after the company's net income in 2008 fell to €395 million, down 17.6%.

The future will bring an influx of glaucoma patients due to an aging population as well as more patients with angle-closure glaucoma, stemming from an influx of immigrants. Increasing the efficiency of the clinical and business sides of the glaucoma practice is a must for survival in this changing environment. Some procedures that can increase cost efficiency include gonioscopy and tailoring visual field testing to the patient.

One needs to have an understanding of materials, designs, and changes in processes of manufacture to appreciate today's high-tech quality options. Knowing where materials and designs originated helps in seeing the road from which we traveled, as well as gaining insight into where we are going in the world of ophthalmic lenses.

A number of factors should be considered when choosing a spectral-domain optical coherence tomography system. Although the capabilities of many systems essentially are similar, some differences exist based on ease of image acquisition and quality, software versatility, and other factors that may make them the best choice for a specific practice's needs. Proprietary technology (RTVue-100, Optovue Inc.) has the capability to perform both retinal and anterior segment imaging, which may make it a versatile instrument for a general ophthalmology practice, according to one practitioner.

San Francisco-Results of a study using scanning electron microscopy (SEM) analysis to study the ultrastructural characteristics of lamellar flap specimens and stromal beds show marked differences depending on the instrument used for flap creation. The variation noted may have implications for clinical outcomes, said Renee D. Solomon, MD.

San Francisco-Capsular tension rings enhance the optical performance of multifocal IOLs by ensuring centration of the lens and reducing irregularities in the posterior capsule such a folds and wrinkles, said Tobias Neuhann, MD, director, AaM Augenklinik am Marienplatz, Munich, Germany.

San Francisco-A new system combining a modified Shack Hartmann wavefront sensor with a new streamlined phoropter makes measurement of refractive error simpler, more efficient, and more accurate, said Gholam A. Peyman, MD.

San Francisco-Fibrin glue may be a better choice than sutures for patients who undergo primary pterygium surgery with conjunctival autografts, according to Luciano P. Bellini, MD, of the Department of Ophthalmology, Irmandade da Santa Casa de Misericórdia, Porto Alegre, Brazil.

San Francisco-Current methods used to evacuate the capsule of lens epithelial cells and other lens material are not sufficient to prevent late complications of Soemmerring's Ring formation, posterior capsule opacification (PCO), and unwanted fibrosis after pediatric cataract surgery, said Brian Zaugg, BS.

San Francisco-Treatment of the cornea using a novel microwave device is being investigated as a new approach for performing corneal refractive surgery without damaging the epithelium, removing tissue, or compromising structural integrity, said John Marshall, PhD.

San Francisco-Young ophthalmologists should not bow to society's pressure to conform, and they constantly should be challenging the status quo. That was the message from Robert H. Osher, MD, as he delivered the Charles D. Kelman Innovator's Lecture.

San Francisco-Refractive surgeons can take pride in something they typically may not consider: the role they play in public safety.

San Francisco-A practice-to-patient communication service from Smile Reminder helps vision-care providers communicate directly with patients by automatically sending text or e-mail messages.

San Francisco-Refractive-cataract surgeons now have a tool to guide the outcomes of their cataract procedures (ORange Intraoperative Wavefront Aberrometer, WaveTec Vision).

San Francisco-When performing wavefront-guided surface ablation for the treatment of varying degrees of myopia, similarly good visual and refractive outcomes are achieved whether using alcohol or a microkeratome for epithelial delamination and whether the flap is removed or replaced, according to the results of a retrospective, single-center study reported by Sadhana Kulkarni, MD.

San Francisco-Gaussian fitting on inverse normalized pachymetry maps enables quantification of the depth and width of focal thinning associated with keratoconus and is showing promise as a new method for diagnosing this corneal ectatic disease, said David Huang, MD, PhD, of the University of Southern California, Los Angeles.

San Francisco-Both ultrasound pachymetry and a proprietary Scheimpflug imaging device (Galilei Dual Scheimpflug Analyzer, Ziemer Ophthalmic Systems) produced excellent repeatability of central corneal thickness (CCT) measurements, and the repeatability was strong for both "virgin" and post-refractive eyes, according to Mitchell P. Weikert, MD, MS, assistant professor of ophthalmology, Baylor College of Medicine, Houston.

San Francisco-The dynamic stimulation aberrometer provides "objective and observer-independent measurements of accommodation and is a suitable instrument for the planning of treatment of presbyopia," said Matthias Elling, MD, Ruhr University Eye Hospital, Bochum, Germany.

San Francisco-Simultaneous topography-guided PRK with riboflavin/ultraviolet A (UVA) corneal collagen crosslinking is showing promise as a safe and effective approach for treating eyes with progressive keratoconus, said Ronald R. Krueger, MD, medical director, Department of Refractive Surgery, Cole Eye Institute, Cleveland Clinic, Cleveland, OH.

San Francisco-Intraoperative subtraction pachymetry may be less accurate and more prone to measurement error than postoperative optical coherence tomography (OCT) measurements, according to Yohko Murakami, MA, Stanford University School of Medicine, Stanford, CA.

San Francisco-Results of a study using an ex vivo model suggest a possible role for air bubble-induced trauma in loss of endothelial cell density after Descemet's stripping automated endothelial keratoplasty (DSAEK), said Anna Hong, MD, a resident at the Duke University Eye Center, Durham, NC.