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A proprietary device for optical coherence tomography (Visante, Carl Zeiss Meditec) seems to be a highly useful addition to clinical practice. The instrument, according to one physician, may be the best resource thus far to evaluate placement of intracorneal segments, femtosecond laser-enabled keratoplasty, and penetrating keratoplasty.

Proprietary instrumentation (Ocular Response Analyzer, Reichert Ophthalmic Instruments) is useful in ophthalmology, but the current generation of the instrument may have some limitations, according to one physician.

Confocal microscopy can be used for refractive surgery to address concerns regarding wound healing and the interface, especially when assessing different techniques. The technology also can be used to assess problems after LASIK regarding dry eye.

A recent study assessed the consistency and repeatability of skilled refractive surgeons in detecting the iris boundary from the infrared camera of a proprietary excimer laser (STAR S4 IR, Advanced Medical Optics) and used as a gold standard for evaluating the platform's automated system. Results show that both methods provide a level of centration accuracy consistent with quality vision results.

A new version of an ophthalmic ultrasound system has the unique ability to image all aspects of the anterior segment. As a key differentiator to optical coherence tomography, the ultrasound system, which has a high-frequency B-probe, enables the user to see behind the iris and create dynamic movies rather than static images.

An automated glaucoma risk indicator using digital color fundus photos proved to be accurate in the detection of glaucoma disease in a recent study. This novel technique is not intended to replace other state-of-the-art diagnostic techniques currently used . Ophthalmologists, however, can receive a confirmation from this automated diagnosing system that the diagnosis they are making in regards to glaucoma is the right one.

Several preoperative features have been identified as important risk factors for ectasia after laser refractive surgery, particularly in patients undergoing LASIK for high myopia or myopic astigmatism. This complication can occur in the absence of any of these findings, however.

A 50-year-old Haitian-born woman pre­sented to the Bascom Palmer Eye Institute with a complaint of suddenly decreased vision in her right eye over the previous 4 days. The patient denied other symptoms of pain, redness, photophobia, floaters, or photopsias.

Postoperative endophthalmitis in an Asian population develops more often in left eyes, among men, and following phacoemulsification, according to an epidemiologic study of cases over 7 years conducted in Singapore.

Patients desiring laser vision correction are treated with phototherapeutic kertectomy and PRK with mitomycin-C either simultaneously or in a staged approach depending on the absence or presence of epithelial ingrowth. A retrospective review of 15 eyes that developed a buttonhole or near buttonhole during LASIK flap creation shows favorable visual outcomes can be achieved.

Vaccines may have a role in corneal and external ocular disease, specifically for herpes zoster virus and human papilloma virus infections, because of the successes of the vaccines in preventing systemic diseases.

Immunohistochemical studies have shown that the receptor for advanced glycation end products (RAGE) is elevated in the optic nerves of patients with Alzheimer's disease. Future studies are expected to provide more information about the role of RAGE in Alzheimer's disease and other neurodegenerative diseases and could lead to new therapeutic options if RAGE is determined to be a causative agent.

The National Ophthalmic Disease Genotyping Network (eyeGENE), developed in 2007 by the National Eye Institute, is a repository of inherited eye disease DNA samples that can be used anonymously for research. The hope is that eyeGENE will facilitate discovery of new ophthalmic disease genes, help researchers identify genetic modifiers of disease, and enhance patient enrollment in clinical trials.

Both subconjunctival and intravitreal injection of the broad-acting, small molecule sirolimus were shown to be safe in a phase I study of patients with diabetic macular edema. Promising efficacy signals also were observed.

The development of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor drugs is a rare event, with an incidence of 0.03% for treated cases and 0.02% for culture-positive cases.

Three monthly injections of ranibizumab, 0.3 and 0.5 mg, appear to provide benefit to patients with macular edema due to central retinal vein occlusion or branch retinal vein occlusion. Foveal thickness decreased significantly with both doses, and there was a concomitant increase in the visual acuity. Most patients require more than three injections to maintain the benefit. The average duration of treatment and the final visual outcomes are not yet known.