Articles

The techniques and materials employed for cataract surgery have improved significantly over recent years, resulting in enhanced functional surgical outcomes, smaller incision sizes and reduced incidences of astigmatism and endophthalmitis. Consequently, cataract surgery has become the most frequently performed surgery in Germany, with around 600,000 conducted each year.

I embarked on a memorable trip to Africa recently and, along with a wonderful team of skilled ophthalmologists and nurses, we set up two eye camps in Namibia and Zambia. Our mission was to study corneal thickness in native Africans so that we could, in the future, establish the relationship between corneal thickness and glaucoma in this population.

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May 2005 saw the birth of the term Microphakonit, when Agarwal removed cataracts using a 0.7 mm phaco needle tip with a 0.7 mm irrigating chopper, through the smallest incision ever documented.

Twenty-five years ago, our algorithm for glaucoma treatment was drop, drop, drop, pill, laser, surgery

EVER traces back its roots to the late 1980s when, following a decision made during the Association for Eye Research (AER) meeting in Granada, Spain, the AER and the European Community Ophthalmic Research Association (ECORA) joined forces to create JERMOV (Joint Meetings in Ophthalmology and Vision), headquartered in Montpelier, France. The idea behind the amalgamation was to unite societies with a common interest and to create a larger, stronger, European society, dedicated to innovation in vision and eye research. By 1997, JERMOV had evolved, the society was reformed, its headquarters moved to Belgium and the name EVER was born to better reflect the society's mission ? to advocate and support research, development and innovation in vision and eye research. The society's offices are, today, housed alongside those of the Belgian Ophthalmological Society in Leuven.

New technologies, advances in phacoemulsification and better instruments have improved outcomes and reduced complications in cataract surgery. However, a similar advance has not been achieved in the same manner with intraocular lens (IOL) development.

Meticulous wound closure is key to success with this implant, as well as patients having realistic expectations about visual acuity outcomes after implantation

Conventional trabeculectomy aims to control IOP by way of a guarded fistula between the anterior chamber and sub-conjunctival space via leakage past the scleral flap. The resulting bleb is often seen to form under the anterior conjunctiva, where Tenon's layer and the conjunctival tissue are thinnest, predisposing patients to bleb-related complications at or near the limbus. Complications include cystic bleb formation, blebitis, endophthalmitis, dellen ulcer and bleb dysaesthesia, the use of anti-metabolites often compounding these problems.

PR Pharmaceuticals and OSI Pharmaceuticals have entered into an exclusive agreement to develop a sustained release formulation of the neovascular AMD treatment Macugen (pegaptanib sodium injection).

Since the late 1960s, trabeculectomy has been the operation of choice for improving aqueous outflow in glaucomatous eyes. Still today it remains the gold standard for glaucoma filtration surgery, with ophthalmologists accumulating a considerable amount of experience with the procedure, its advantages and its limitations.

Use of intravitreal triamcinolone acetonide (IVTA) has increased significantly over the past four years as a consequence of successful reporting of the agent's efficacy in the treatment of cystoid macular oedema resulting from uveitis, birdshot retinochoroidopathy, central retinal vein occlusion and diabetic macular oedema.1-6

The role of vitrectomy must be defined and compared with intravitreal triamcinolone and laser treatment, but vitrectomy may provide a more permanent solution for some eyes

In my hands, 23-gauge vitrectomy is the one procedure for 99% of my cases

The month of February witnessed the first approval of an anti-angiogenesis therapy for the treatment of age-related macular degeneration (AMD) in Europe. The European Commission granted marketing authorisation for Macugen (pegaptanib sodium injection) for the treatment of neovascular AMD.

It was a real pleasure to meet with some of you at the ESCRS Winter Meeting in Monte Carlo last month. The event was a great success for me; not only was I able to escape the miserable climate afforded by the typical English Winter, but I got to see some wonderful people there who, not only were a joy to meet and speak with, but who also provided me with extremely valuable feedback and support. Thank you!

Brown syndrome is defined as an ocular motility disorder, characterized by an inability to elevate the adducted eye actively or passively. The causes can be congenital or acquired, and the problem can be permanent or transient. Clinically, Brown syndrome is characterized by a significant limitation of elevation in the adducting position that occurs in the majority of cases and improved elevation is usually apparent in the midline, with generally normal elevation in abduction. Exodeviation (V pattern) can occur on elevation in the midline. Many patients are orthophoric in the primary position, although sometimes hypotropia can develop with a compensatory face turn towards the opposite eye. A positive forced duction test is usually the hallmark of Brown syndrome.

Since we have been using the femtosecond laser, we have not had to fit a single therapeutic contact lens

Refractive surgery has radically changed the nature of clinical practice, with its success spawning the proliferation of commercial clinics owned and directed by non-medical personnel

The impotence drugs Viagra (sildenafil) and Cialis (tadalafil) may increase the risk of developing non-arteritic anterior ischaemic optic neuropathy (NAION), according to a study published in the February 2006 issue of the British Journal of Ophthalmology.

Challenging phacoemulsification cases can present problems for the cataract surgeon. How a surgeon manages those challenging cases can prevent the case from turning into a nightmare.

New techniques and technology in cataract surgery was the theme of a symposium Wednesday night at the World Ophthalmology Congress. The symposium touched on new phacoemulsification technology, the use of a new ophthalmic viscophthalmic device (OVD), anti-infectives, and the latest intraocular lens technology.

Performing "safe surgery" remains as the sine qua non for using antimetabolites safely and effectively as an adjunct to trabeculectomy. However, there are some strategies that can be incorporated in the surgical technique to reduce the risk of complications resulting from the application of anti-scarring medication, said Richard K. Parrish, II, MD, at the World Ophthalmology Congress.

Exfoliation syndrome (XFS) is a global disease that is important to recognize because of its association with other visual-threatening ocular pathologies, said Alan H. Robin, MD, of the Wilmer Eye Institute at Johns Hopkins University in the United States.

Deep sclerectomy is not the holy grail of glaucoma surgery, but available evidence indicates that it is definitively safer than trabeculectomy and that it can result in long-term success rates matching those of trabeculectomy when performed with proper technique by experienced hands, said Tarek M. Shaarawy, MD, at the World Ophthalmology Congress.

Ophthalmologists are familiar with the use of optical coherence tomography (OCT) for the back of the eye. Now, there also is a role for OCT in anterior segment corneal procedures and complications, reported Ronald Smith, MD, of the United States at the World Ophthalmology Congress on Wednesday.

Early detection of glaucoma is critical. According to the AGIS study, by the time a reproducible visual field defect is detected, 20% to 50% of the retinal nerve fiber layer (RNFL) can be damaged, said Remo Susanna, Jr., MD, at the World Ophthalmology Congress on Wednesday.

Glaucoma implants may fail for a number of reasons, said Felix Gil Carrasco, MD, at the World Congress of Ophthalmology on Wednesday. However, inappropriate patient selection and improper placement of the shunt are probably the most common reasons.

Increasing clinical experience with corneal collagen cross-linking using combined topical riboflavin application and ultraviolet-A (UVA) irradiation indicates this simple, nonsurgical intervention may be an effective treatment for keratoconus and iatrogenic keratectasia. However, its safety may depend on respecting a minimum corneal thickness threshold of 400 microns as a criterion for candidate selection, said Theo Seiler, MD, at the World Ophthalmology Congress.