News

Developments in refractive surgery are interdependent and encompass diagnostics, surgical technology, and supportive therapeutics, all of which have a common goal: emmetropia. A number of advances have grabbed the attention of refractive surgeons over the past year, such as improvements in lasers, materials, and refinements in indications for certain refractive procedures. Wavefront technology is still taking center stage.

Portland, OR-The addition of the burst mode to the Millennium Phacoemulsification System (Bausch & Lomb, Rochester, NY) is a boon to the system, according to a recent study. Using the burst mode during cataract surgery reduces the amount of energy that enters the eye, which allows for a less invasive procedure and improved visual outcomes.

Munich, Germany-The aspheric Z9000 IOL (Tecnis, Pfizer) is associated with better mesopic contrast sensitivity relative to conventional IOLs, but does not maintain its superiority to spherical implants when testing is performed under mesopic conditions with glare, said Mike P. Holzer, MD, at the European Society of Cataract and Refractive Surgeons annual meeting.

Although advanced nuclear sclerotic cataracts are seen with less frequency within the average U.S. practice, the rock-hard cataract does occasionally present in our examining lane and on the operating table. These dense lenses can be some of our most difficult cases due to numerous intrinsic challenges including poor visibility, fibrotic or fragile anterior capsules, large lens size, adherent cortical capsular connections, a thin or deficient epinucleus, and tenacious leathery lens fibers. Special considerations should allow the surgeon to approach these advanced cataracts with more confidence and decrease the incidence of serious intraoperative complications.

Tokyo-A new approach to phacoemulsification incorporating prechopping and the Legacy (Alcon) system with its NeoSonix handpiece (Alcon) equipped with a specially designed ultrasound tip (Akahoshi tip) and using the AdvanTec short burst mode allows removal of even hard cataracts with a minimum of ultrasound energy, said Takayuki Akahoshi, MD.

Leaders in cataract surgery agree the past year has been a time of significant developments in both technique and technology.

Santa Monica, CA-A temporal hinge LASIK flap technique significantly increases the area of treatable corneal stromal bed for a given flap diameter compared with a superior hinge flap and offers a number of other advantages, including enabling retention of a broad hinge, said Kerry K. Assil, MD.

Marblehead, MA-As the year draws to a close, U.S. ophthalmologists are taking an assessment of where things stand in their practices and in the world around them. Many are finding comfort in the knowledge that the ophthalmic market continues to hold its own in an uncertain economic climate, said Kenneth P. Taylor in an independent analysis of the vision-care sector.

Rochester, NY-Bausch &Lomb is looking to the future and the past as it celebrates the FDA acceptance of a new drug application for its new anti-inflammatory/antibiotic combination product while marking the company's 150 years in business.

Boston-A recent study found that optical coherence tomography (OCT) seems to be more sensitive to changes in the retinal nerve fiber layer over time compared with standard visual field testing in patients with glaucoma, according to Gadi Wollstein, MD.

Parma, Italy-YAG laser iridotomy has a protective effect in patients with pigment dispersion syndrome (PDS) who are at high risk of developing pigmentary glaucoma, according to the results of a 10-year follow-up study from the Institute of Ophthalmology in Parma, Italy.

Cincinnati, OH-Early results from an FDA clinical trial suggest that the toric implantable contact lens (ICL, STAAR Surgical) is extremely promising as a safe and effective alternative to LASIK for the correction of myopia with astigmatism, reported David Schneider, MD.

New Orleans-Cyclosporine 0.05% ophthalmic emulsion (Restasis, Allergan) appears to be safe and effective in enhancing clinical outcomes in patients with dry eye who wish to undergo LASIK, said George M. Salib, MD.

Wayne, PA-Use of a simple tool allowing objective determination of glare can lead LASIK candidates to appreciate existing problems preoperatively and through that awareness, potentially reduce the likelihood of complaints about new or exacerbated glare postoperatively, said Steven B. Siepser, MD, a private practitioner in Wayne, PA.

Heidelberg, Germany-The aspherical Tecnis Z9000 IOL (Pfizer) achieves good centration and maintains a stable position in the capsular bag to provide continued good refractive reliability and favorable functional results, said Klio A. Becker, MD, who is a member of the Heidelberg IOL and refractive surgery research group, department of ophthalmology, University of Heidelberg.

Elmhurst, IL-The design of the Tracey-Visual Function Analyzer (Tracey-VFA, Tracey Technologies) makes it a rapid, efficient tool for evaluating preoperative and postoperative LASIK patients, said Donald Sanders, MD, PhD, Center for Clinical Research, University of Illinois-Chicago, Elmhurst, IL, who has conducted research on the Tracey-VFA.

San Diego-In the future, clinicians will be better able to prevent, detect, and treat rhegmatogenous retinal detachment, according to William R. Freeman, MD.

Greenwich, CT-As a child and Azerbaijani immigrant, Vadim Filatov, MD, was a victorious chess champion. He rose from poverty, studied at Yale and Harvard, and became an enterprising ophthalmologist who was among the first to offer LASIK in the Greenwich area.

Bethesda, MD- Ten patients with late-stage retinitis pigmentosa (RP) will be the first humans to receive intraocular, polymer implants containing genetically modified human retinal epithelial cells that researchers hope will prevent further vision loss.

Yokneam, Israel-The FDA has given marketing clearance to Lumenis for its Novus TTx, its 810-nm infrared diode photocoagulator.

Atlanta-CIBA Vision Corp. has received CE Mark approval to market its Centurion SES EpiEdge epikeratome for use in Epi-LASIK procedures.

Fort Lauderdale, FL-The FDA has given GMP Companies Inc. its approval to expand a phase III clinical trial of its Eyepass glaucoma implant.

Apathy is defined in Webster's unabridged dictionary as "a lack of interest, or indifference." Apathy, coupled with an unwillingness to get involved or to speak out on issues, is endemic among the medical profession.

The year 2003 has been one of solid progress in glaucoma research and management, agree experts in the field.

Retinal specialists have reason to be excited this year, especially in the arena of developing treatments for age-related macular degeneration (AMD). In contrast to roughly 5 years ago, when only laser was available to arrest progression of extrafoveal vessels, now an array of approaches is on the horizon.

Refractive lens exchange is a safe and effective procedure for providing multifocal vision, and will ultimately become the treatment of choice for presbyopia, said Stephen F. Brint, MD.

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.