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CE-marked since October 2004 and approved by the FDA in March 2005, the ReZoom IOL (AMO, Santa Ana, California, USA) was designed to provide hyperopic cataract patients with greater independence from glasses, although good visual outcomes can also be achieved in other patients. However, patient selection is essential and one of the criteria that candidates for multifocal IOLs must fulfil is an adaptable and open-minded personality. Patients should not have unrealistic expectations and should not be looking for perfect vision. Surgeons must also emphasize to patients that neuroadaptation is required to adjust to a new visual system and this might take a few months.

Since its inception in 1956, the European Society of Ophthalmology (SOE) has grown from a small entity into a conglomerate of national ophthalmological societies from all 40 European countries, representing more than 40,000 European ophthalmologists. We speak with President Zdenek Gregor about the changing face of the society, the importance of collaboration and the way the society has adapted to an ever-evolving Europe.

Happy New Year to you all and welcome to the second edition of Ophthalmology Times Europe.

Published in the September/October 2005 edition of Journal of Refractive Surgery, Thomas Hammer and colleagues compared the quality and reproducibility of cuts produced by four automatic microkeratomes, and found that each performed similarly on overall quality of cut surface, with one out of the four, performing exceptionally better than the rest on quality of cut edge.

The 2005 annual meeting of the American Academy of Ophthalmology (AAO) saw the event record the third highest attendance figures in its history.

The implantation of IOLs in the eye has been part of cataract surgery practice for many years; however, it is only in more recent years that these implants have become available for refractive correction. To date, the resulting vision outcomes have been impressive. In fact, most refractive surgeons believe phakic IOLs will become the procedure of choice for certain forms of refractive correction. Because patients are wary of the perceived invasive nature of this procedure, however, phakic IOLs still have a long way to go in the race to gain patient popularity and trust.

In a bid to enter the growing area of angiogenesis inhibition, Bausch & Lomb has announced the formation of two collaborations, both involving they licensing of anti-angiogenesis compounds for possible ophthalmic use.

The bimanual technique still has a role to play even if it is now possible to perform a coaxial phaco through a microtunnel

European ophthalmologists are earning the respect of those envious of the European passion for crossing boundaries in ophthalmology and venturing into the unknown

This procedure has distinct advantages over conventional surgery for keratoconus and may eventually supersede it

Unlike trabeculectomy, canaloplasty is a non-penetrating procedure that reduces the chance of inducing cataract or causing anterior segment inflammation

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AquaLase? lens removal is an exciting new method, offering benefit to both cataract and refractive patients. The system is designed to work with the INFINITI? Vision System from Alcon. In theory, this technique was to be fully equivalent to phacoemulsification, but in fact, several important differences exist.

I would like to share my clinical experience with the AcrySof? ReSTOR? intraocular lens (IOL) in patients with cataract. We performed a prospective study of 63 eyes of 32 patients (31 bilateral and 1 unilateral). All surgeries were performed by 1 of 2 surgeons, and second eyes were operated on within 2 weeks of the first eye. The inclusion criteria were senile cataract with corneal astigmatism less than 1.5 diopter (D) and IOL power between 16 and 25.5 D; ocular comorbidity was excluded. Based on these criteria, about 56% of our cataract patients were eligible. Our outcome measures were both refractive status and quality-of-life issues.

Robert J. Cionni, MD

The AcrySof? ReSTOR? lens is the first apodized diffractive intraocular lens (IOL) to become available, and clinical results with this lens seem to be different from those seen with older technology. We're familiar with previous lens technology, either zonal refractive or full aperture diffractive designs. I will discuss the advantages and disadvantages of these older designs and explain how the new AcrySof? ReSTOR? lens represents a breakthrough technology.

Refractive lens exchange has become the procedure of choice for correcting high ametropia in the presbyopic patient. From the refractive surgeon's perspective, the AcrySof? ReSTOR? lens is a wonderful option for refractive lens exchange. It is safest in eyes without high or excessive axial length. Until recently, the only implants available for refractive lens exchange were monofocal intraocular lenses (IOLs). These provided patients with a single focal point, either for reading or for distance. The Array? multifocal IOL became available several years ago, but my experience, and the collective experience of many other surgeons, was that this zonal refractive, multifocal IOL did not provide a satisfactory result for most patients.

Robert J. Cionni, MD

The surprising outcomes of the European Glaucoma Prevention Study (EGPS) can be accounted for by a number of explanations and should not be interpreted as meaning that lowering IOP has no benefit for glaucoma, said Harry A. Quigley, MD.

I often feel that the European ophthalmology industry is becoming the victim of its own success. With the half-life value of ophthalmic knowledge on the continent now set at less than five years, compared with 30 years in 1960, innovation in Europe is not showing any signs of slowing down. Ophthalmologists in Europe are continuously required to update and broaden their specialist knowledge with the advent of new techniques, treatments, instruments and devices. With meetings every few weeks, around the globe, on all branches of ophthalmic science and clinical practice, how is it possible to keep up?

Are you aware of all of the ophthalmology societies that operate around Europe? Do you know what they strive to achieve, how they came to be, who their key figureheads are, for example? You are probably familiar with some of the ophthalmology societies that are out there in Europe, but maybe not so familiar with what they're up to.

Despite recent advances and the promise of new therapies for the treatment of choroidal neovascularization (CNV) resulting from age-related macular degeneration (wet AMD), key challenges remain. These include improving vision outcomes, reducing the numbers of treatments and proving efficacy in different lesion types. While treatment for wet AMD has traditionally centred on monotherapy regimens, the future standard of care may likely focus on combination strategies.

1991 witnessed the birth of the European Society of Cataract and Refractive Surgeons (ESCRS); a new kind of society aimed at unifying specialists and societies across a number of disciplines throughout the continent. Society President, Professor Marie José Tassignon talks to OTE about her vision for the future.

The FDA has denied Genentech's request to fast-track the application for its age-related macular degeneration (AMD) agent, Lucentis (ranibizumab). In response, Genentech announced it plans to file a complete Biologics License Application (BLA) for Lucentis for the treatment of neovascular AMD in December 2005, in a bid to speed up the process. Although the FDA rejected Genentech's request for fast-track designation, this should not affect the timing for BLA submission or the potential to obtain priority review.

With lengthening follow-up, the posterior chamber ICL (STAAR Surgical) continues to be associated with encouraging results in the management of refractive amblyopia in children who have failed conventional therapy with contact lenses or spectacles, said Laurence C. Lesueur, MD.