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The future of refractive lens exchange is quite promising, according to refractive guru I. Howard Fine, MD, who spoke during the AAO's refractive subspecialty day meeting. He predicted that refractive lens exchange will some day become the dominant refractive procedure because it is able "to address all components of patients' refractive errors, including presbyopia."

The recent FDA approvals of two laser eye surgery systems could significantly change the face of ophthalmology, according to several surgeons.

Chicago-IOP control remains the basis for primary treatment of glaucoma, but there have been some recent changes in the medical and surgical arenas. Now, a prostaglandin analogue is often used instead of a beta-blocker as first-line therapy, selective laser trabeculoplasty (SLT) has emerged as another option for primary laser surgery, and meanwhile, there is growing patient interest in complementary medicine alternatives.

Lubbock, TX-A special coating developed by Texas researchers may eventually save the nearly 35 million American contact lens wearers the hassle of removing and cleaning their contacts every night, or even every month.

Rochester, NY-For pediatric ophthalmologist Gary D. Markowitz, MD, having an ophthalmic dispensary has been a positive experience in terms of patient service as well as practice growth.

Patients considering refractive surgery are understandably nervous about undergoing procedures on their eyes. A physician who can listen to their concerns and address them all will gain their trust and their business.

For clinicians, the Internet can become a valuable tool for disseminating information on their practices and, ultimately, in attracting new patients.

A sign of an excellent company is one that capitalizes on its strengths, minimizes its weaknesses, takes advantage of its opportunities, and recognizes its threats, according to James V. Mazzo, president and chief executive officer of Advanced Medical Optics (AMO).

Chicago-Bleb leaks occur in 2% to 7% of eyes after filtering surgery and are important to recognize and treat because they can be a precursor to other complications, including ocular hypotony, blebitis, and endophthalmitis.

With the change in the weather, kids have settled back into the school routine and many fall sports have started up again. Unfortunately, along with the increase in organized and pick-up sports, more sports-related eye injuries are possible. More than 40,000 eye injuries each year are attributed to sports trauma.

Chennai, India-Phakonit (Phako with a Nee-dle Incision Technology) is a bimanual approach to phacoemulsification performed with a needle opening via an incision and with the phaco tip. The technique drastically reduces incision size, and with the ad-vent of ultra-small incision IOLs, it offers cataract patients the advantages of astigmatism-neutral sur-gery with return to stable vision within 4 to 5 days after surgery, said Amar Agarwal, MD, an innovator of the technique.

New York-Treatment with ranibizumab (Lucentis, Genentech) resulted in stable or im-proved vision in 97.5% of patients with wet age-related macular degeneration (AMD) over 6 months, according to the phase Ib/II trial results. Forty-five percent had more than a three-line gain in vision, said Jeffrey S. Heier, MD, a principal investigator in the clinical trial, who reported results at the annual meeting of the American Society of Retina Specialists.

We often hear how cataract surgery is becoming refractive surgery. In fact, cataract surgery became refractive surgery when Sir Harold Ridley implanted the first IOL. While cataract extraction provides an immediate benefit by clearing the optical media, the patient must rely on the refractive power of the IOL for the rest of his or her life. Getting that refractive power right falls within the purview of refractive surgery, and it involves more than inserting the IOL into the capsular bag.

Charleston, SC-In an ongoing prospective study, conventional and custom wavefront-guided LASIK have been shown to achieve uncorrected visual acuity (UCVA) outcomes exceeding the FDA grid, but there are dramatic differences favoring the wavefront-guided approach in analyses of treatment effects on higher-order aberrations, said Kerry D. Solomon, MD.

The Terry-Schanzlin Astigmatome System with vacuum speculum (Oasis Medical Inc.) is a disposable microsurgical cutting instrument designed to make uniform and controlled paralimbal incisions that are often used in combination with cataract and lens implant pro-cedures to reduce astigmatism.

Rochester, NY-The Technolas 217 Z Zyoptix Personalized Vision Correction system (Bausch & Lomb) was approved by the FDA for use in the United States last month (see related news on Page 1). About 99% of patients expressed extreme satisfaction or satisfaction with the visual results afforded them by the system, which may increase patient interest in refractive surgery.

Pekin, IL-Results from 6 months of follow-up in the Allegretto Wave (WaveLight Laser Technologie, Erlangen, Germany, and Lumenis) hyperopic LASIK clinical trial demonstrate excellent efficacy, safety, accuracy, and predictability, said William I. Bond, MD.

The new keratoprosthesis, AlphaCor (Argus Biomedical Pty Ltd., Perth, Western Australia), while not the first of its kind, seems to be more user-friendly for corneal transplant surgeons than human tissue.

The incidence of overcorrection after LASIK for myopia is low, but the results of re-treatment are variable. Re-treating often results in a shift back to myopia, leaving the patient unhappy. To improve the results of LASIK enhancement surgery, a new formula is warranted. In 1999, Drs. Lindstrom and co-workers noted that laser treatment achieved different effects in eyes with primary versus secondary hyperopia. They attributed this effect to dynamics of wound healing.

Editor's Note: The eye is the window to our body's health. In this month's column, we examine two ocular findings in children that have led to the discovery of life-threatening kidney disease and examine the life of the physicians who made these connections.

The development of wavefront technology is a major advancement in refractive surgery. It appears to deliver overall better results than conventional LASIK, thereby increasing patient expectations. It is imperative that refractive surgeons interested in continuing to perform laser-vision correction develop expertise with this technology. As with all transitions this, too, has a learning curve that must be conquered.

Irvine, CA-Refractec Inc. has filed its pre-market approval application with the FDA for a conductive keratoplasty (CK) procedure designed for patients with presbyopia.

Newtown Square, PA-Americans age 40 and older say their biggest obstacle to laser-vision correction procedures is concern over safety, according to a survey by AllAboutVision.com.

Paris-Neurotech SA is initiating a phase I clinical trial of NT-501, its lead Encapsulated Cell Technology (ECT) product for the treatment of retinitis pigmentosa (RP).

Fountain Hills, AZ-Coronado Industries has expanded its exclusive agreement with an Italian distributor to include Algeria, Morocco, Libya, and Tunisia.

Mason, OH-The FDA has approved Haag-Streit International's new pachymeter, which uses Optical Low Coherence Reflectometry (OLCR) to send a light beam to measure corneal thickness.

Des Plaines, IL-Micro-thin prescription inserts (Intacs, Addition Technology Inc.) may be used to reduce or eliminate myopia and astigmatism in patients with keratoconus for whom restoration of functional vision is no longer possible with contact lenses or glasses, under a new designation by the FDA.

New York-Allergan Inc. will pay nearly $230 million in cash to acquire Oculex Pharmaceuticals Inc., a privately held company specializing in the development of treatments for sight-threatening diseases of the eye.

Monrovia, CA-The FDA's Ophthalmic Devices Panel of the Center for Devices and Radiological Health is recommending that STAAR Surgical Co.'s Implantable Contact Lens (ICL) be approved with conditions for use in correcting ?3 to ?15 D of myopia and reducing myopia in the range of ?15 to ?20 D.

Here are the top 10 reasons why it is important to attend the 2003 annual meeting of the American Academy of Ophthalmology (AAO) this month in Anaheim, CA.