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.
In a fluidics test of three phacoemulsification machines, differences were found in vacuum, flow, and postocclusion surge-and these differences were found not only between the three machines but also between the machines' own settings and what they were actually delivering. Other important findings: there is a significant amount of unoccluded vacuum at the tip, and the parameters for what constitutes a safe postocclusion surge can be dramatically different among eyes.
Optical coherence tomography performed preoperatively can predict the surgical success rates and the visual acuity outcomes in patients with myopic macular holes.
Laser photocoagulation seems to be associated with stable rates of visual acuity up to 2 years after treatment for diabetic retinopathy.
Lens-sparing vitrectomy for IV retinopathy of prematurity provides a good anatomic success rate and achieve good visual acuity success rates. Forty-two weeks postmenstrual age seems to be the ideal time for surgery.
In the current era of presbyopia-correcting IOLs, toric IOLs, and aspheric IOL technology, the practice milieu is changing.
Low rates of ocular and nonocular adverse events were found in patients receiving either 0.3 mg or 0.5 mg of ranibizumab (Lucentis, Genentech) for neovascular age-related macular degeneration. Final 1-year results from the safety study of over 2,300 patients showed that rates of adverse events were similar to those found in other large studies of ranibizumab.
A recent study evaluating the efficacy of an investigational dexamethasone delivery system (Posurdex, Allergan) for the intravitreal treatment of uveitis in rabbits demonstrated that it significantly reduced intraocular inflammation.
Pre-meeting subspecialty day activities will offer updates on the latest advances that can be applied immediately to the ophthalmic practice. Here some sessions taking place on both Friday and Saturday.
The annual meeting of the American Academy of Ophthalmology in Atlanta Nov. 8 to 11 will be held in conjunction with the European Society of Ophthalmology. Keynote speaker Michael T. Osterholm, PhD, MPH, will discuss the effects of infectious diseases on health care. The joint meeting will be packed with scientific presentations, instructional courses, breakfast with the experts, practice management courses, and symposia, plus an opportunity to see what is new from industry in the exhibit hall.
Changing demographics in the United States will require ophthalmology practices to adopt strategies to deliver care to large numbers of diabetic and elderly patients. Possible steps could include more effective use of support staff and increasingly efficient practice patterns.
U.S. documentary film director Joseph Lovett he has been progressively losing his vision since glaucoma was diagnosed in him 20 years ago. He is making a film, "Going Blind," to document the effects that blindness has on people's lives and to relay his own experience with the condition.
Neil M. Bressler, MD, Susan B. Bressler, MD, Alexander J. "Sandy" Brucker, MD, and Stanley Chang, MD, were honored for their work in the subspecialty of retina Oct. 12 at the annual meeting of the American Society of Retina Specialists.
Fixation preference testing for detecting amblyopia in infants and toddlers is unreliable, according to researchers.
A topical ophthalmic corticosteroid (Durezol, Sirion Therapeutics) indicated for the treatment of inflammation and pain associated with ocular surgery is now commercially available.
Prevent Blindness America is reminding everyone to make sure all Halloween purchases are safe and responsible. In the past, cosmetic contacts were popular costume accessories, allowing wearers to change eye color or give the illusion of cat?s eyes.
The 18-month data of a proprietary epiretinal brachytherapy (NeoVista) for the treatment of wet age-related macular degeneration were made public at the recent Retina Society annual meeting.
The best practices learn how to hire, train, and retain the best staff, manage patient and staff issues and physician relationships according to Ian Maltzman the administrator for Fromer Eye Centers in New York City. Because Fromer Eye Centers has a very complex organizational structure, including a president, administrator, and a chief operating officer, Maltzman has had to find ways to manage the complex structure.
New administrators at an ophthalmic practice should start by learning every non-medical aspect of the practice, including finances, computer maintenance, patient satisfaction components, and staff requirements and rewards systems.
The typical difficult patient can ruin a perfectly good day at your practice if you let them. By not taking it personally and keeping your cool you can successfully deal with this type of patient without adding stress and frustration for you or the patient.
Practices can increase their efficiency by performing surgery in only one location, having multiple operating rooms (ORs) and an efficient preoperative area available, using anesthesia blocks preoperatively instead of topical anesthesia in the OR, choosing a safe and reliable phaco technique that minimizes surgical time, and hiring well-trained staff members.
When making a differential diagnosis of idiopathic uveitis, remember that several malignant and non-malignant syndromes can masquerade as the condition. Making the correct diagnosis early allows prompt institution of appropriate therapy and avoids unnecessary treatment.
Three combinations of IOLs for the correction of presbyopia were evaluated in a retrospective analysis. The results favored a mix-and-match approach using the (AcrySof ReSTOR, Alcon Laboratories) and the crystalens (crystalens, eyeonics) for better range and quality of vision, according to one surgeon.
In patients who have suffered multiple immunologic graft rejections, the chance of providing good-quality vision is dramatically increased with a keratoprosthesis than another transplant. Patients who receive a keratoprosthesis have rapid visual return, a good quality of vision, and a high rate of graft survival.
Bilaterial implantation of a refractive multifocal IOL (ReZoom, Advanced Medical Optics) can result in high satisfaction rates among patients undergoing cataract surgery or refractive lens exchange when proper patient selection, aggressive correction of residual refractive error, and early intervention for posterior capsule opacification are part of the strategy, according to a retrospective study of 71 patients.
An Ectasia Risk Factor Score System developed by researchers at Emory University appears to be a valid method for identifying patients at risk for ectasia after LASIK, according to a retrospective review of 171 cases of post-LASIK ectasia and 186 controls with normal postoperative courses.
A technique for obtaining digital photographs under standardized conditions was developed as the foundation for scientific assessment of IOL glistening size and severity, which ultimately will be used to investigate visual impact.
A novel prosthetic device (Boston Scleral Lens) is custom-designed to vault the cornea over an oxygenated reservoir of artificial tears. It is designed to correct corneal first surface aberrations and address symptoms of dry eye disease.
Evaluation of low contrast sensitivity outcomes after wavefront-guided refractive surgery in U.S. Air Force aviators shows quality of vision returns much faster after LASIK compared with PRK.
An aberrometer is being developed to provide cataract and refractive surgeons with a tool for intraoperative assessment of refraction to improve results of astigmatic correction techniques and IOL power selection. Outcomes in an ongoing clinical trial are encouraging.
