News

London-Subconjunctival injection of botulinum toxin type A (Botox, Allergan) can offer an effective treatment for upper eyelid retraction associated with thyroid eye dis-ease, said Jimmy M. Uddin, MD.

San Francisco-Patients who repeatedly miss appointments or do not follow prescribed treatment plans can be walking litigation time bombs, according to attorney Paul Weber, JD, a risk manager at the Ophthalmic Mutual Insurance Co.

With daily operating costs rising, reimbursement rates declining, and concerns over soaring liability insurance prices, profitability is a hot topic for the modern ophthalmology practice. Some groups are finding an effective solution in the symbiosis between ophthalmology and optometry. By adding optometrists to their staffs, ophthalmologists are offering a more complete vision-care package to their patients and driving up profits in the process. The advantages, as seen by the doctors involved in these relationships, are many.

Reseda, CA-The Centurion SES Microkeratome, recently approved by the FDA, has features that differentiate it from conventional microkeratomes used for standard LASIK procedures: a combination blade/cartridge component, a bar applanator, and a resultant gutterless flap.

San Francisco-The new zero-compression head for the Hansatome microkeratome (Bausch & Lomb) represents an important safety advance for that instrument because it significantly reduces the risk of intraoperative epithelial defects compared with the standard head, said Thomas Kohnen, MD, at the American Society of Cataract and Refractive Surgery annual meeting.

San Francisco-Refractive surgeons using the MK-2000 (Nidek) microkeratome can expect to achieve high-quality flaps whether using the manufacturer's own or another's blade, but they need to recognize that blades from different manufacturers and even from different lots of the same manufacturer may produce flaps that can vary dramatically in thickness, said Robert T. Lin, MD, at the American Society of Cataract and Refractive Surgery annual meeting.

San Francisco-The CB Single Use microkeratome (Moria, Antony, France) is a reliable instrument for flap creation, offering advantages in safety and ease of use, said Karl B. Stonecipher, MD, at the American Society of Cataract and Refractive Surgery annual meeting.

San Francisco-The femtosecond laser (IntraLase FS, IntraLase Corp.) holds promise as a useful tool for performing keratectomy in eyes undergoing lamellar keratoplasty procedures, said Melvin A. Sarayba, MD,at the American Society of Cataract and Refractive Surgery annual meeting.

San Francisco-LASIK surgeons seeking to create thin flaps in order to maximize ablation depth while maintaining a 250-?m stromal bed would be prudent to set 120 to 130 ?m as their lower limit for intended flap thickness, said Lee T. Nordan, MD, at the American Society for Cataract and Refractive Surgery annual meeting.

The Kawai Capsulorrhexis Forceps (model AE-4388, ASICO) are designed for use in difficult cases of continuous curvilinear capsulorhexis (CCC), according to their creator, Kenji Kawai, MD.

The pupil that dilates poorly is frequently associated with both glaucoma and complications during combined surgery. With newer endolenticular techniques, especially with nucleofractis procedures and chop techniques, pupils do not need to be as large as previously required.1-4 However, there still are numerous instances in which the pupil is inadequate to allow the surgeon to proceed, and some form of manipulation or surgery is required.

Atlanta-When performing aphakic IOL calculations in eyes that have undergone corneal refractive surgery, contact lens over-refraction is the single best method for determining the value of corneal power (K). When preoperative K is known, averaging values obtained from both contact lens over-refraction and the keratometric history technique yields even better results. Nevertheless, both techniques remain suboptimal, yielding highly variable results, according to George O. Waring III, MD.

When Bruce Koffler, MD, brought optical dispensing into his practice, he was not convinced completely that it was a good idea. That was 3 years ago. Now, he wishes he had done it sooner.

San Francisco-Corneal topography and wavefront data are key to assessing the internal aberrations of the eye accurately and are essential for surgeons to perform customized ablations accurately, said Stephen D. Klyce, PhD, who spoke during the Innovator's Session at the American Society of Cataract and Refractive Surgery annual meeting.

San Francisco-Refractive surgery continues to evolve as researchers strive to achieve better quality of vision for patients, said Ioannis G. Pallikaris, MD, PhD, the first ophthalmologist to deliver the Charles D. Kelman Innovator's Lecture at the American Society of Cataract and Refractive Surgery annual meeting.

Editor's Note: What has 100 years of history done for ophthalmic knowledge? In many areas-cataract surgery for example-a revolution has occurred and great strides have been made. In others, surprisingly, very little has advanced.

San Francisco-Creativity is the key to innovation and can best be described by the three "I"s-inspiration, insight, and intuition-according to Charles D. Kelman, MD.

Rochester, NY-Bausch & Lomb will delay the regulatory filing for the intravitreal fluocinolone acetonide implant (Retisert), a treatment for diabetic macular edema (DME), for up to 3 years while the FDA reviews 12-month safety data of additional eyes treated with implants.

San Francisco-The BD K-4000 microkeratome (Becton, Dickinson & Co.) can be used reliably to create high-quality flaps of predictable dimensions, said Robert M. Kersh-ner, MD, at the American Society of Cataract and Refractive Surgery annual meeting.

Fort Lauderdale, FL-Novartis Ophthalmics and QLT Inc. have received the 2003 Helen Keller Prize for Innovation in Eye Care for their development of verteporfin for injection (Visudyne) therapy.

Somerset, NJ-MedPointe Inc. has acquired all U.S. and Canadian rights to azelastine HCl (Optivar), a treatment for itching of the eye associated with allergic conjunctivitis in adults and children ages 3 and older.

STAAR Surgical has submitted the final module of its FDA pre-market approval papers for its implantable contact lens (ICL).

Dublin, CA-Carl Zeiss Meditec Inc. has purchased worldwide distribution rights to a new perimetry device for the detection and management of age-related macular degeneration (AMD).

A loading forceps (American Surgical Instruments Corp. [ASICO]) is designed to set an IOL in the cartridge easilyand rapidly and without damaging the lens surface. The device, the Akahoshi Acrylic Loading Forceps AE-4253, was designed by Takayuki Akahoshi, MD, director of the Mitsui Memorial Hospital in Tokyo, Japan.

Heidelberg, Germany-The accommodative power of a new accommodative IOL is about 1 D compared with that of a monofocal IOL that provided pseudoaccommodation of about 0.5 D, according to Gangolf Sauder, MD, and Jost Jonas, MD.

Dayton, OH-Move over a few disc diameters from the optic nerve head to assess the retinal thickness in the para-macular region for early diagnosis and close monitoring of the glaucomatous process. That's the message of Talia Technology Inc., Tampa.

Durham, NC-Corneal thickness should be taken into account when assessing a patient's risk profile for progression from ocular hypertension to glaucoma, according to a Duke University glaucoma specialist.

Milwaukee-The approach to repairing a bleb leak in the office needs to be in the context of what will provide the greatest benefit for the patient with the least amount of risk, according to glaucoma specialist Dale K. Heuer, MD.