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Complications take center stage in cataract surgery arena

The year 2006 may be characterized as an interesting one in cataract surgery, according to ophthalmologists who are opinion leaders in the field.

Complications have occupied a place on center stage, torsional phacoemulsification using the OZil Torsional Handpiece and the Infiniti Vision System (Alcon Laboratories) has generated significant enthusiasm as a major technologic advance, future developments are being anticipated in ultrasound technology from other manufacturers, and interesting trends are emerging as newer IOL technology is being put to the true test of outcomes assessment in clinical practice.

TASS. Early in 2006, an outbreak of toxic anterior segment syndrome (TASS) was identified, and with support from the American Society of Cataract and Refractive Surgery (ASCRS), a task force was quickly organized to investigate the underlying cause(s). That panel issued its final report in October, and although no single major etiologic factor or "smoking gun" was identified, the group should be commended for its thorough assessment of the issue and efforts to develop recommendations and guidelines for avoiding TASS in the future, said Dr. Fine, clinical professor of ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland.

"The lack of a definitive answer to the cause of the outbreak is the most interesting aspect of this story," said Dr. Olson, the John A. Moran Presidential Professor and chairman, Department of Ophthalmology and Visual Sciences, University of Utah Health Sciences Center, Salt Lake City. "I suspect that the rise in cases was not just due to greater awareness leading to increased reporting but rather that there was some causal factor that escaped identification."

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