News

The Bascom Palmer Eye Institue, University of Miami School of Medicine, sweeps three categories-Best Overall, Best Residency, and Best Clinical (Patient Care) Programs-in the 13th annual Ophthalmology Times' Best Programs survey. The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, takes the top honors for Best Research Program. Chairpersons and residency directors from U.S. departments of ophthalmology ranked programs nationwide.

The value of telemedicine is well established, but some limitations in image quality do exist. An objective evaluation of the images overrides the limitations, however. Imaging provides a great opportunity for research. More data on cost effectiveness of various screening modalities are needed in patients with retinopathy of prematurity.

The FDA Amendments Act of 2007 established requirements related to controlled clinical trials of drugs that ultimately would be subject to FDA regulation.

Updating your Web site-not just once, but frequently-offers an excellent opportunity to boost your practice's business by developing new patient relationships using the Internet.

Ophthalmic practice administrators often find heavy demands on their time and attention and so, like many managers, risk losing sight of what's important in the rest of their lives. But while it isn't possible to avoid the stresses and strains that accompany the job, there are ways administrators can maintain or restore a sense of balance in their lives.

An office manager should be interested in implementing change and improvements within a practice, but that should not be done without an operational assessment.

Reimbursements for ophthalmic practices are steadily declining while costs are going ever higher, leaving practices scrambling as never before to find new sources of revenue and ways of cutting costs. But unless these goals are approached wisely they can lead to stress among both staff and doctor.

Current Procedural Terminology (CPT) is updated regularly, often in response to difficulties reported by practitioners. Practices that fail to keep up with the changes experience negative consequences on revenue and compliance. Staying familiar with changes in CPT can be very useful, and potentially quite rewarding.

Significant changes in cylindrical measurements were observed following unilateral horizontal strabismus surgery in a retrospective study. In addition, investigators found clinically significant changes in a large number of operated eyes as well as a portion of control eyes.

A study in a rat model found retinal ganglion cell loss and retinal thinning following excitotoxic damage. This finding has led researchers to speculate that axonal damage and excitotoxicity are related, and that the connection may be through the Wallerian degeneration gene. Future research into this pathway could lead to new forms of treatment for glaucoma and other neurologic diseases.

Surgical outcomes were compared in a retrospective study of 76 eyes with a miniature glaucoma shunt (Ex-PRESS, Optonol) implanted and 77 eyes that underwent standard trabeculectomy. The two procedures were associated with similar IOP-lowering efficacy, but the shunt procedure had a benefit for reducing the risk of hypotony.

Considerable progress has been made in recent years in the understanding of the epidemiology of dry eye disease. Here, two doctors discuss some of the studies that have helped ophthalmologists understand the prevalence, burden, and risk factors of dry eye disease. They also highlight how improved diagnosis will have a significant effect on the quality of life of patients with dry eye.

A retrospective study of eyes undergoing wavefront-guided PRK, LASIK with a mechanical microkeratome, or LASIK with a femtosecond laser shows that biomechanical changes are affected by flap creation technique and ablation depth.

Is bilateral implantation of an IOL better than contralateral "mixing and matching" of lenses? In one cross-study comparison, postoperative visual outcomes were examined to compare the effectiveness of bilateral implantation of an apodized diffractive IOL versus contralateral implantation of one apodized diffractive IOL and one refractive zonal progressive IOL.

Advanced surface ablation with mitomycin C is more effective than LASIK for treating ametropic after corneal transplantation, according to results of one study.

A retrospective study evaluated complications and associated outcomes in eyes that underwent LASIK with femtosecond laser flap creation at a university-based refractive surgery center. A direct or indirect complication due to flap creation occurred in 44 (0.92%) of 4,772 eyes; there was no loss of best spectacle corrected visual acuity in any of the 44 eyes.

A Talbot-Moiré wavefront aberrometer developed for use during cataract surgery is being investigated for its potential to enhance the accuracy of astigmatic correction with limbal relaxing incisions, toric IOL alignment, and IOL power selection.

Accumulating experience with corneal collagen crosslinking indicate it is a safe and effective treatment for arresting progression of keratoconus. However, further studies are needed to better characterize its indications and contraindications.

Review of a small series of eyes shows surface ablation procedures do not eliminate the risk of postoperative ectasia in eyes with forme fruste keratoconus, even in eyes without other ectasia risk factors.

An excimer laser platform features technology for automated cyclotorsional compensation. A study comparing outcomes of patients undergoing LASIK for myopic astigmatism treated with and without the system demonstrates that its use increases the predictability of astigmatism correction.

A retrospective study including 800 eyes compared outcomes using the Zyoptix XP (Bausch & Lomb) to create 120 μ flaps and the Hansatome (Bausch & Lomb) to create 160 μ flaps. Safety was excellent overall, the 120 μ flaps created with the Zyoptix had better thickness predictability and were associated with faster re-epithelialization and less discomfort.

A retrospective analysis has found favorably low enhancement rates using a wavefront-optimized excimer laser platform (WaveLight Allegretto Wave, Alcon).

According to a prospective study, epi-LASIK seems to have two advantages compared with PRK performed with a mechanical microkeratome: faster visual recovery and less postoperative pain.

The hardware and software used in refractive surgery has undergone a steady evolution that has resulted in more precise refractive outcomes.

Results of retrospective studies comparing haze after PRK in eyes treated with 0.002% mitomycin C (MMC) versus no MMC and in eyes treated with 0.002% MMC versus 0.02% MMC suggest an approach for using MMC in clinical practice.

Outcomes of wavefront-guided LASIK performed using a proprietary excimer laser (STAR S4 IR, Advanced Medical Optics) are superior to those achieved when the laser is used for conventional LASIK, and the benefits associated with the wavefront-guided procedure appear to persist even when the iris registration function cannot be used.

New guarded knives (Sharpoint, Angiotech) retain their sharpness far longer than other disposable blades, and this durability translates into the ability to perform more procedures with the same instrument and to make cleaner, faster-healing incisions, according to one ophthalmologist.

Cataract surgical techniques and IOLs have both been evolving for many years. The advances have been-and continue to be-tremendous, but each new advance also has the potential to give birth to new complications. The need to suture clear corneal incisions to prevent potentially blinding complications during subsequent surgery, and the dislocation of one-piece IOLs and capsular tension rings, are examples of complications of which practitioners need to be aware.