News

Washington, DC &#8212 The American Society of Cataract and Refractive Surgery (ASCRS) issued a paper last year regarding the mission to deliver safe and effective cataract surgery services to all Medicare patients and that all beneficiaries have the right to "essential services," explained Priscilla P. Arnold, MD, immediate past president of ASCRS and the chairman of the government relations committee.

Washington, DC &#8212 Simultaneous bilateral cataract surgery offers increased efficiency over unilateral cataract surgery by as much as 15%. However, practitioners are slow to adopt this procedure because of low reimbursements, explained Steve A. Arshinoff, MD, a practitioner based in Toronto, during the refractive/cataract socioeconomic symposium held at the American Society of Cataract and Refractive Surgery annual meeting.

Washington, DC &#8212 Growing the refractive surgery market relies on educating potential candidates about the benefits of the procedure and allaying irrational conclusions about risks, reported Shareef Mahdavi, MD.

Washington, DC &#8212 The ophthalmic industry was given a sound bill of health in an independent analysis of the market. Kenneth P. Taylor, OD, provided an overview of the ophthalmic market in terms of trends, growth, and the view from Wall Street in a presentation at the American Society of Cataract and Refractive Surgery annual meeting.

Washington, DC &#8212 LASIK remains the refractive procedure of choice for the majority of refractive surgeons and patients worldwide. However, surface ablation is a reasonable alternative that may even offer some advantages overall and be a preferred technique in select patients, said Helen K. Wu, MD, at the American Society of Cataract and Refractive Surgery meeting.

Washington, DC &#8212 It's an annual rite of spring: each year the American Society of Cataract and Refractive Surgery (ASCRS) passes the baton from one leader to another. Roger Steinert, MD, assumed the presidency of the society during its general session Saturday morning.

Washington, DC &#8212 Cataract surgery has improved in terms of safety and efficacy with the introduction of phacoemulsification, foldable IOLs, and the use of smaller incisions.

Panama City, Panama—An artificial iris dia-phragm implant (NewIris, Kahn Medical Devices) that changes the color of the eyes is safe, easy to implant, well tolerated, and has a more natural appearance than contact lenses, said Delary A. Kahn, MD.

Cardiovascular medicine has provided a road map that ophthalmology can follow in risk assessment.

It may be a little harsh to say that battle lines are drawn, but it is not stretching the imagination any to see that there are distinctly different opinions being debated on eye examinations for preschool children.

When I was a boy, my father mentioned several times how he might have purchased IBM stock decades earlier, and how much such an investment would have been worth at the time. Often, people tell me how they refrained from purchasing a waterfront home because the price seemed way too steep, only to have the value subsequently shoot up 10-fold. Perhaps we all regret not making certain purchases long ago.

Atlanta—Arterial dissection can be overlooked in a patient who presents to an ophthalmologist with acute orbital or periorbital pain. Val?rie Biousse, MD, described the appropriate steps to take to ensure an accurate diagnosis and avoid a subsequent cerebral insult.

Stryker, OH—An old "sap" lives in northwest Ohio—or better yet, an old tree full of sap. As a hobby, David Brounley, MD, enjoys producing maple syrup on his 55-acre property and sharing the sweet concoction with his wife and other loved ones.

About one out of every six people had some anxiety that appeared to be associated with their retinal disease.

Rochester, NY—Differentiating between migraine and transient ischemic attack at first may appear daunting, but a careful history-taking with attention to the details of the particular attack should help sort things out.

Austin, TX—Volume loss is an important aspect of post-enucleation socket syndrome (PESS), resulting from the inability of the prosthetic orbital implant to replace all of the volume lost from an enucleated or eviscerated socket. Fortunately, there are a number of effective techniques for volume augmentation in PESS, said John Shore, MD, FACS, who is in practice with Texas Oculoplastic Consultants, Austin, TX.

Selective laser trabeculoplasty (SLT) can be used at a variety of intervention points in the treatment of glaucoma. The effect varies, depending on the treatment history of the patient.

Dorado Beach, Puerto Rico—Recognizing that non-compliance and non-adherence are common among patients being treated with medical therapy for glaucoma, clinicians need to determine if medication is being used as prescribed, and if not, the reasons why, said Marshall N. Cyrlin, MD, at the Current Concepts in Ophthalmology meeting, sponsored by Johns Hopkins University School of Medicine and Ophthalmology Times.

St. Louis—The main lesson to be learned from the Ocular Hypertension Treatment Study (OHTS) is that not every patient with ocular hypertension needs to be treated, according to Michael A. Kass, MD, a professor in the department of ophthalmology and visual sciences at Washington University in St. Louis, and chairman of the groundbreaking large-scale study.

New approaches to early detection, diagnosis, and management are essential to deal with the public health problem of glaucoma, the leading cause of blindness in the United States. Speakers at a continuing education symposium held during the American Academy of Ophthalmology meeting discussed topics such as the glaucoma continuum, application of the results of large clinical trials, global risk assessment principles, and pharmacotherapy.

Cardiovascular medicine has provided a road map that ophthalmology can follow in risk assessment.

New York—Laser presbyopia reversal (LAPR) is showing significant promise and patient satisfaction based on 12-month follow-up results from a U.S. phase II clinical trial, said Sandra C. Belmont, MD.

Wavefront-guided LASIK yields more accurate corrections and better quality of vision compared with conventional LASIK regardless of which laser system is used, said Robert K. Maloney, MD, at the American Academy of Ophthalmology refractive surgery subspecialty day meeting in New Orleans.

Each of the lasers can cut to depths up to 400 ?m and can create flaps with a minimum thickness of 90 ?m.

Atlanta—Interim study analyses from a multicenter, North American trial indicate LASIK for treatment of hyperopia with or without astigmatism using the Nidek EC-5000 excimer laser is associated with consistently good safety and efficacy outcomes, reported George O. Waring III, MD, the medical monitor for the study.

Conductive keratoplasty (CK) (NearVision, Refractec Inc.) improves near vision in presbyopic eyes and in presbyopic eyes that had undergone an excimer laser procedure.

San Francisco—A number of studies have suggested an increased rate of endophthalmitis with clear cornea surgery compared with scleral tunnel surgery, and potential causes of this increase include incision location, incision architecture and changes in antibiotic prophylaxis, according to David G. Hwang, MD.

Dorado Beach, Puerto Rico—Bimanual microincision phacoemulsification is ready for prime time and expected to have an even brighter future, according to William W. Culbertson, MD, at the Current Concepts in Ophthalmology meeting.

The cartridge allows easy IOL loading, visualization of progression, and implantation through an unenlarged incision.

For the past few years, the lure of ever smaller incisions has enticed cataract surgeons who perform temporal, clear corneal phacoemulsification with topical anesthesia. With a variety of shooters, we have been placing IOLs through 2.5- to 2.8-mm incisions and we feel comfortable with our self-sealing wounds and good results. Still, as many of us recall with previous transitions in our cataract surgery development, taking on a new skill requires stepping out of one's comfort zone to take advantage of even better technology. Such has been the situation with bimanual phacoemulsification.