Cataract & Refractive

There are several surgical options available for the correction of aphakia, yet there is no clear winner in the competition for the best method: anterior chamber intraocular lenses (IOLs), suturing a posterior chamber IOL in the sulcus or using an iris claw lens. If an iris-claw lens, like the Verisyse IOL (AMO), is chosen, it will usually be fixated to the iris in the anterior chamber. Alternatively this IOL can also be fixated on the posterior surface of the iris (Figure 1).

Angle-supported phakic IOLs can no longer be sold or implanted in France because of their association with significant endothelial cell loss, which was discovered in patients two to three years after implantation.

AMO has received FDA approval for the Advanced CustomVue Monovision procedure, the first wavefront-guided procedure for the correction of myopic prebyopes, with or without astigmatism.

Blue-blocking intraocular lenses (IOLs) offer no advantages to the eye and could actually cause health problems such as insomnia and depression.

Although femtosecond lasers offer a strong alternative to microkeratomes, they are not suitable for every situation, according to Theo Seiler, MD.

One surgeon's quest to reduce intraoperative LASIK complications has led to the development of a new multifunctional instrument, which is hoped will help standardize surgical manoeuvres and reduce the need for retreatment.

Prior to the advent of wavefront-guided LASIK, the only parameters that could be modified in order to obtain optical correction for a given patient's refractive error were the sphere, cylinder and axis. This approach, however, would often not yield the ideal optical correction and, in many cases, the post-refractive surgery patient may be able to read the 20/20 line but not clearly. In some cases, best corrected visual acuity (BCVA) would even decrease following surgery. This situation can usually be attributed to the persistence of significant amounts of higher order aberrations (HOAs).

Dr Richard Duffey seeks to answer this question by comparing the results of femtosecond LASIK flaps with those of the mechanical microkeratome.

In recent years, excimer laser refractive surgery has provided solutions for myopia, astigmatism and hyperopia and now it is also taking on the challenges presented by presbyopia.

The quest for safe, effective surgery, which produces optimal results, has prompted much debate among experts on what the best procedure is for performing laser enhancements. For wavefront-guided enhancements, lamellar and surface procedures are both popular methods and I would like to discuss my experience and share my thoughts on their future in refractive surgery.

By mixing and matching diffractive and refractive IOLs, patients can achieve much better all round visual results.

The British intraocular lens (IOL) manufacturer, Rayner Intraocular Lenses, has received pre-market approval (PMA) for its C-flex lens from the FDA making it the first non-US IOL to receive FDA approval in twenty years.

Medennium has obtained CE mark clearance to market its photochromic intraocular lens (IOL), Aurium in Europe, making it the first lens of its kind to be introduced to the cataract lens market.

The US FDA has approved wavefront-guided and mixed astigmatism indications for WaveLight's Allegretto Wave Eye-Q system.

Aspheric-based treatments with the SCHWIND ESIRIS excimer laser and ORK-CAM software offer high predictability, increases in visual acuity (VA) and no induction of aberrations.

AMO has launched an online series featuring US TV star Kristin Cavallari.

Long waiting times have become a progressively important issue, particularly in countries with publicly funded systems.

The AcrySof angle-supported phakic refractive IOL (Alcon) continues to offer patients with high myopia stable and accurate refractive results with excellent visual acuity (VA), according to physicians speaking at the XXIV Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) in London last September.

Correction of very high myopia, i.e. above –9.00 D, remains a controversial topic and new designs of phakic IOLs have spurred great interest in the past five years. Presently, long-term results are becoming available and some interesting conclusions can be drawn, explained Matteo Piovella, MD, who reported his four-year results with one of these lenses at the XXIV Congress of the European Society of Cataract and Refractive Surgeons in London.

Epi-LASIK is safer for patients; it offers a lower risk of ectasia, fewer serious complications and better contrast sensitivity, according to Robert J. Mitchell.

Assessing povidone-iodine as method for preventing endophthalmitis.

The growing popularity of LASIK and other new innovations in refractive surgery is set to push sales in the global market from $1.3 billion in 2006 to an estimated $4.5 billion in 2009, according to market research firm Kalorama Information.

Non-infectious endophthalmitis is observed more frequently after injections of triamcinolone acetonide that contain preservatives (PTA) than after injections of preservative-free triamcinolone acetonide (PFTA), according to a study published online ahead of print in the British Journal of Ophthalmology.

A study published in the March issue of Ophthalmology, has found that many young and middle-aged people of Chinese ancestry who are told they have glaucoma may actually be misdiagnosed. These patients who do not show disease progression may, in fact, have glaucoma-like symptoms caused by myopia.

Statins may have protective effects on the development of both cataract and age-related macular degeneration (AMD), according to a report published in the April issue of the American Journal of Ophthalmology.

Patients undergoing LASIK procedures experience an increase in halos around lights in night vision conditions, according to a study published in the April issue of the British Journal of Ophthalmology.

Bausch & Lomb has received new technology intraocular lens (NTIOL) status for the regular and violet-filtering models of its SofPort Advanced Optics intraocular lenses (IOLs).

Relaxing incisions are a safe and effective method for reducing postoperative astigmatism and help improve visual acuity (VA), according to a study published in the March issue of the Journal of Refractive Surgery.

Intracameral phenylephrine is a straightforward and effective way to prevent the effects of floppy iris syndrome in patients taking systemic tamsulosin and undergoing cataract surgery.

The majority of patients with diabetic macular oedema (DME) who are given an injection of intravitreal triamcinolone (IVTA), will go on to develop cataract.