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Cataract surgery is a modern success story because of the advances in techniques and technology that have been made over the years. Excellent outcomes are becoming routine, and the field only continues to progress, thanks to a steady stream of innovations. Three cataract surgeons share their thoughts on some of the most noteworthy innovations and trends of 2008 and beyond.

We're to the point that medical care for our children is a discretionary item, less of a priority than digital cable. Blurry vision from a cataract is something that can be dealt with next year or whenever the economy sorts itself out. While it may be impossible to peer into the future, it increasingly appears that accessing medical care may not be the recession-proof priority for Americans that it has been in the past.

Allergan Inc. has introduced an over-the-counter artificial tear (Optive Sensitive Preservative-Free Lubricant Eye Drops) for patients who have dry eye or dryness following LASIK.

Clinical trials provide far more information than just the safety and efficacy of a treatment. Information about the natural course and the risk factors of the disease can be gathered. Of equal importance is the collaboration of clinical investigators as they develop and carry out protocols facilitates incorporation of new ideas into medical practice.

Collagen cross-linking, the newest advancement in the refractive arena, possibly will stabilize keratoconic and ectatic corneas. LASIK, an area that always is improving, has seen changes in flap sizes and lasers. Knowledge of corneal biomechanics also is progressing to provide more information than ever before with new instrumentation. The phakic IOL market has expanded considerably, catering to those with high myopia. IOL options for pseudophakia also are expanding, and refractive lens exchange remains popular for hyperopia. In addition, questions of patient satisfaction postLASIK are being answered by an FDA task force.

ISTA Pharmaceuticals has filed a new drug application (NDA) with the FDA for bepotastine ophthalmic solution (Bepreve). If approved, the solution would be used as an eye drop treatment for ocular itching associated with allergic conjunctivitis.

The American Academy of Ophthalmology (AAO) 2008 joint meeting with the European Society of Ophthalmology, held in Atlanta Nov. 8 to 11, featured strong attendance numbers. Preliminary figures for attendance at the meeting were approximately 22,000, and attendance at the Subspecialty Day events Nov. 7 and 8 totaled more than 6,200.

Prevent Blindness America (PBA) announced it has been awarded a 3-year cooperative agreement from the Centers for Disease Control and Prevention (CDC), with a first-year grant of $1 million.

Once you get employees to realize that their success or failure ultimately is up to them, the pressure is off you as a manager. The pressure is squarely in the place it needs to be: on the employees. Your only job then becomes augmenting their growth with the tools they need to be the hardest-working technicians you ever will have.

Children who have convergence insufficiency (CI) will respond better to weekly treatment sessions with a trained vision therapist than to a strictly home-based eye exercise program, according to a study released by the National Institutes of Health (NIH).

Determining the optimal size for an optical dispensary will allow the practice to obtain the highest return on investment and return on assets. The optimal size can be calculated in one of two ways. The first is to determine the number of dollars each square foot of space can generate. The second method is to calculate the percentage of total practice revenues the dispensary represents. Whichever method is used, remember the general rule for dispensary size: "bigger is better."

Visual merchandising is the art of displaying merchandise to encourage sales. Dispensing ophthalmology practices can create eye-catching displays by following some simple rules. Grouping frames by price point and brand helps to organize options for the customer. Displays can highlight individual brands through repetition, a pyramid design, using odd, rather than even numbers of items, considering the texture of background materials, and more.

Carl Zeiss Meditec and Optovue announced that they have resolved their legal disputes pending in the Northern District of California and in Massachusetts Superior Court.

The novel technology found at the heart of an adaptive optics flood illumination fundus camera (AOFIFC, INOVEO)-an electromagnetic deformable mirror (Mirao 52-e, Imagine Eyes)-is designed to facilitate the acquisition of even higher resolution images than those captured by optical coherence tomography systems.

Both subjective and objective evaluation of diabetic macular edema (DME) can produce good results. In a recent study, the initial results of objective evaluation with retinal imaging technology (Heidelberg Retina Tomograph Retina Module, Heidelberg Engineering) showed good sensitivity and moderate specificity, whereas subjective evaluation by two expert assessors produced high sensitivity and specificity. Nevertheless, with optimization, the results of the two forms of evaluation became more evenly matched, suggesting that the retinal imaging technology can aid clinicians in detecting DME.

1-year results from the HORIZON open-label extension study of ranibizumab (Lucentis, Genentech) for the treatment of exudative age-related macular degeneration show that treatment beyond 2 years relatively is safe and well tolerated, but previously treated patients who received ranibizumab monthly for 2 years may be susceptible to loss of vision with less-frequent dosing during the third year of treatment.

Adjuvant use of bromfenac ophthalmic solution 0.09% (Xibrom, ISTA Pharmaceuticals) with ranibizumab (Lucentis, Genentech) reduced the reduced the number of ranibizumab injections needed to control choroidal neovascularization secondary to age-related macular degeneration. Use of the two drugs together resulted in better visual acuity outcomes than those achieved with ranibizumab alone.