Cataract & Refractive

The M2 microkeratome (Moria), the Carriazo-Pendular microkeratome (Schwind) and the IntraLase femtosecond laser all create flaps of predictable thickness.

Incision sizes needed to remove cataracts have been significantly reduced by new technology, such as the vision enhancement system (Stellaris; Bausch & Lomb) which allows surgeons to make two 1.8 mm cuts on either side of the eye.

A study published in the January issue of Antimicrobial Agents & Chemotherapy, has found that the high proportion of corneal infections linked to contact lens solutions are fuelled and made resistant to treatment by the formation of a highly resistant structure of microbial cells held together with a glue-like matrix material, called biofilms.

The use of glaucoma drainage surgery is decreasing in Britain, which may be explained by an increase in cataract extraction, according to a report published in the January issue of Eye.

Using a telemedicine system to assist ophthalmologists in developing countries with the diagnosis and management of various ophthalmic conditions can be successful.

Wavefront-guided LASIK is a safe and efficacious way to correct moderate to high myopia and compound myopic astigmatism.

In eyes that have undergone corneal refractive surgery, non-Goldmann measurements of intraocular pressure (IOP) and continued examination of the optic nerve is essential as changes of the corneal shape can lead to falsely low IOP values.

A more holistic approach to patient referral and rehabilitation provision for people with low vision is required.

Modern intraocular lenses (IOLs) transmit only a part of the spectrum, just like natural lenses, but the transmission of the natural lens changes with age. With increasing age, the lens becomes far less transparent in the violet/blue part of the visible spectrum. Can the transmission of an IOL, therefore, be compared to that of the natural lens at a certain age? In other words, can we assign a virtual age to an IOL? The answer is yes and such an age is far easier to interpret than the complicated transmission curves provided by industry.

Sreening for early ectatic disease is essential in the evaluation of the refractive surgical candidate. There have, however, been many cases of severe post-LASIK ectasia without evidence of preoperative risk factors. Improving preoperative screening with better detection of subtle corneal topographic abnormalities may therefore help eliminate these rare but devastating cases.

Refractive surgery has come a long way since the first lamellar refractive surgeries were performed decades ago. Through continuous fine-tuning and evolution, LASIK has become today's dominant refractive procedure. However, as with all medical procedures, there is always room for improvement.

Cataract surgeons agree that proper incision construction is paramount for achieving good postoperative stability that will reduce the risk for endophthalmitis. The safety of the clear cornea incision technique versus use of other incision types remains controversial, however.

As a modern ophthalmic surgeon, I feel a reading test for clinical practice must be highly standardized, accurate, easy and quick to perform, whilst also offering the opportunity to perform research.

New developments in diagnostic technology should enable better screening and follow-up of refractive surgery patients, said Dan Z. Reinstein, MD, delivering a keynote address during the refractive surgery subspecialty day preceding the annual meeting of the American Academy of Ophthalmology in November 2007.

The anti-inflammatory nepafenac 0.1% is more comfortable and at least as efficacious as ketorolac 0.5% in the prevention and treatment of postoperative ocular pain and inflammation.

Femtosecond lasers create highly reproducible flaps that correspond with preoperative intended thickness.

With regards to maintaining corneal biomechanics, sub-Bowman's keratomileusis (SBK) and advanced surface ablation (ASA) are improvements over conventional LASIK.

Elliptical excimer laser penetrating keratoplasty (EELPK) is an effective method of improving visual acuity.

Poor traffic gap judgement in patients with peripheral field loss (PFL) raises important safety concerns for their safety when crossing the road.

Patients who undergo LASIK may have an increased risk of developing depression, according to reports from the US.

LASIK in 2007 represents a wonderful world that can provide excellent efficacy, safety, and stability.

Surgically induced refractive errors can compromise vision following penetrating keratoplasty.

A new cataract gene's location and defect in the coding region was discovered.

Medically well-controlled glaucoma patients and patients with exfoliation syndrome may experience intraocular pressure (IOP) elevation shortly after cataract surgery. This can be controlled by the instillation of timolol maleate 0.5%.

Sub-Bowman's keratomileusis (SBK) is associated with a low complication rate.

The use of intravitreal dexamethasone (IVD) is not warranted as a routine adjunctive treatment in postoperative endophthalmitis.

People who are dissatisfied with the results of LASIK are more likely to be referred to a cornea service by their doctor than by their LASIK surgeon.

Topical nonsteroidal anti-inflammatory drugs often are administered for off-label purposes to patients who are undergoing cataract surgery, but surgeons should consider the cost, the risks, and the evidence available to support such use.

Microincision cataract surgery (MICS) does not degrade the optical quality of the cornea or induce a modification in corneal astigmatism.

LASIK for myopia over -10 D is both safe and effective in the long-term.