Twenty-gauge vitrectomy has been the standard management technique for pediatric cataract for many years. Recent success with 25-gauge instruments, however, opens the door for ophthalmologists to have confidence when handling complex anterior segment surgeries in children.
A new video overlay system (Surgical Media Center, Advanced Medical Optics) uses specialized media software for intraoperative video capture and customizable playback. The system offers high-storage capacity, creates DVD quality recordings, and has comprehensive playback and editing options. These features make it appropriate for quality assurance documentation and as a tool for self-improvement, teaching, and creating video and slide presentations.
A new micro-coaxial surgical system (Intrepid, Alcon Laboratories), featuring a low-compliant fluid management system with low-compliant tubing, suppressed surge and maintained an equivalently satisfactory stable chamber during quadrant removal at a lower bottle height-up to 35 cm less-compared with another fluidics management system by the same manufacturer (Infiniti, Alcon Laboratories), 90 cm compared with 125 cm.
Repositioning using scleral suturing and iris suturing of IOLs and IOL exchange result in similar outcomes for lenses that have decentered or dislocated. Repositioning of the lenses can be associated with redislocation, and IOL exchange can be associated with retinal detachment and development of endophthalmitis. The preferred approach should be individualized to each patient by considering several factors, the most important of which are the material and position of the lens.
Anterior segment optical coherence tomography (AS-OCT) performed preoperatively with a proprietary system (Visante, Carl Zeiss Meditec) in patients with very shallow anterior chambers who are undergoing cataract surgery improves the safety of the procedure. AS-OCT allows surgeons to modify the surgical strategy. Double filling with cohesive and dispersive ophthalmic viscoelastic devices can preserve the surgical space.
Visualization during cataract surgery in patients with corneal opacities can be improved using relatively simple techniques of capsular staining and dimming of the microscope light.
Toxic anterior segment syndrome (TASS) outbreaks occurring at four cataract surgery centers in Canada launched a comprehensive investigation to identify the possible cause(s). Use of a specific brand of textured surgical gloves (Triumph LT, Medline) was identified as a factor, and new cases of TASS have been avoided since use of that particular product was discontinued.
The use of 25-gauge transconjunctival chandelier endoillumination during cataract surgery in patients with severely opacified corneas is proving to be a boon for surgeons and patients alike. The technique facilitates clear intraocular visualization, and because the chandelier does not have to be held in place, the surgeon can perform capsulorrhexis and subsequent manipulations bimanually as usual.
Radial optic neurotomy and peeling of the internal limiting membrane seems to be a surgical treatment for retinal venous occlusive disease that can obtain permanent reperfusion of the retina, in contrast to intravitreal drugs that have only a temporary effect.
Trends found in a small retrospective study comparing primary chemotherapy and primary external-beam radiation therapy in the treatment of retinoblastoma could set the stage for a more comprehensive, international study. The initial study of 25 cases of bilateral retinoblastoma meeting strict inclusion criteria found that chemotherapy was associated with a slightly higher frequency of enucleation whereas radiation was associated with a slightly higher frequency of death.
A review of the RAND Health Insurance Experiment results reveals that many of its conclusions are relevant today.
A 20-item questionnaire is expected to be useful for evaluating the health-related quality of life of adults with strabismus and practical application in a clinical setting. The patient-derived questionnaire assesses both psychosocial and functional aspects of strabismus.
The challenging task of controlling patients' IOP can be made more difficult by several factors that can cause fluctuations in IOP. Those factors include posture, blood pressure, cerebrospinal fluid pressure, and even sleep, and they can hinder physicians' efforts to provide consistent control of IOP.
Performing LASIK in patients with glaucoma should be carefully considered before making the commitment because of changes in the eye that might result in lower IOP measurements, according to two ophthalmologists. PRK, however, might be a better option for this subgroup of patients, suggests one surgeon.
Santa Ana, CA-Advanced Medical Optics (AMO) and the Institute for Eye Research (IER) are collaborating to develop contact lens disinfectant and cleaning solutions and related products, AMO announced.
Intrableb pigmentation may be a positive sign in bleb filtration surgery, said Boonsong Wanichwecharungruang, MD, from Rajavithi Hospital, Bangkok, Thailand.
The value of telemedicine in patients with retinopathy of prematurity (ROP) is well established, according to Birgit Lorenz, MD, Pediatric Department of Ophthalmology, University of Regensburg, Germany. The technology provides opportunities for research, allows expert discussion by specialists worldwide, and allows objective evaluation of the pathology.
HIV has become a manageable chronic disease, but that is true only in developed countries with a relatively small number of HIV cases. It is possible to have a normal lifespan with controlled disease using the drugs that are currently available, but this treatment is needed globally, according to William Lynn, MD, Department of Infectious Disease, Ealing Hospital, London.
The use of an artificial cornea in patients who have experienced multiple immunologic graft rejections is more likely to result in good-quality vision than is performing another corneal transplant, said Michael W. Belin, MD, Albany Medical College, Albany, NY.
Posterior uveitis can be difficult to manage in children, but manage it you must, said Susan Lightman, MD, PhD, FRCP, FRCOphth, Department of Clinical Ophthalmology, Institute of Ophthalmology, University College, London.
When treating a child with amblyopia, what steps do you take when the Pediatric Eye Disease Investigator Group (PEDIG) guidelines do not work? The first thing to consider is whether you're getting poor compliance with your therapy, said Lionel Kowal, MD, FRACOphth, FRACS, Ophthalmology Eye and Ear Hospital, Melbourne, Australia.
Either patching or atropine sulfate 1% to occlude the sound eye offers lasting benefits to patients with amblyopia, according to Michael X. Repka, MD, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore. Atropine is not approved for use in ambyopia, he said.
Intraoperative floppy iris syndrome (IFIS) can be approached in a number of ways depending on the surgical scenario, according to David Chang, MD, University of California, San Francisco.
The importance of treating dry eye disease was the subject of "Advances in dry eye: disease perspectives, treatment options, and post-surgical management," a symposium held here in conjunction with the World Ophthalmology Congress (WOC).
In a symposium, entitled ?Progressive thinking: advances in the diagnosis assessment and management of glaucoma,? a panel of glaucoma specialists provided their expertise on imaging, risk factors that determine glaucoma progression, and understanding angle-closure glaucoma (ACG).
Glaucoma progresses at different rates among patients, and this variability poses a challenge for the ophthalmologist trying to manage the disease. IOP is a well-known risk factor and often is monitored carefully in patients with glaucoma. However, visual field and optic nerve deterioration are direct indicators of progression, and their status also should be considered when developing an initial treatment plan.
Using various types of IOLs in the same patient has been trumpeted as a way to achieve better vision correction than bilaterally implanting the same IOL. Yet, this concept of "mix and match" is not quite that simple, said Rubens Belfort, MD, Vision Institute, Federal University, Sao Paulo, Brazil.
Surface excimer laser and application of topical mitomycin C 0.2% results in increased vision when used to treat refractive errors after penetrating keratoplasty, said Michael Lawless, FRACO, from the Vision Eye Institute, Chatswood, New South Wales, Australia.
Achieving the proper IOL power for patients who have had a refractive procedure such as LASIK, PRK, or RK can be challenging, and taking more measurements leads to greater accuracy, said Jack T. Holladay, MD, MSEE, FACS, Holladay LASIK Institute and Baylor College of Medicine, Houston.
Erythropoietin (EPO), ciliary neurotrophic factor (CNTF), and wolfberry seem to provide neuroprotection of retinal ganglion cells in a rat model of ocular hypertension, according to Kwoh-fai So, PhD, chairman of the Department of Anatomy, University of Hong Kong.
