Cataract & Refractive

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Recognising the harmful effects of various light rays on the retina, manufacturers have set about developing IOLs with various light filtering properties. Here, Boris Malyugin and Tatiana Fadeeva put the YellowFlex lens to the test.

Intracorneal rings (Intacs, Addition Technology) to correct keratoconus appear to yield better results when only one ring segment is implanted inferiorly rather than two segments implanted, one superiorly and one inferiorly, explains Joaquim N. Murta, MD, PhD.

A study reveals that the negative spherical aberration-inducing quality of the aspheric Tecnis Z9000 results in reduced ocular spherical aberration and improved mesopic contrast sensitivity.

Microincision cataract surgery (MICS) and phacoemulsification result in similar visual outcomes and early endothelial cell loss.

Senior doctors have accused the independent sector treatment centre (ISTC) scheme for NHS cataract services of being an expensive over-reaction to the need to increase the rate of cataract surgery in the UK.

Manual small incision cataract surgery (MSCIS) with trypan blue staining of the anterior capsule is a safe and effective method of cataract extraction for patients with phacolytic glaucoma.

The ICARE anterior chamber phakic intraocular lens (IOL) with angle-supported haptics was designed five years ago by Corneal Laboratories (France) and attained the CE mark for demonstrating good efficacy and stability of refractive outcomes for the correction of high myopia. However, the safety profile of the lens was compromised by a number of anatomical limitations: a high vaulting that placed the optic too close to the endothelium and, because of the overall design of the lens, accurate sizing was difficult. In our clinic, in a series of 44 cases of conventional ICARE implantations, there were three reports of ovalisation and two of endothelial cell density decrease, which necessitated the removal of the lens.

Removal of soft cataracts with Aqualase (Alcon), theoretically carries less risk to the posterior capsule than phacoemulsification.

Could phakic IOLs some day emerge as the dominant refractive surgical approach, particularly considering the past problems with early innovations? This is a difficult question to answer but one that has been debated over recent years.

As with any IOL implantation technique, there are some potential complications that must be considered. In general, the number of complications is low, and most of them are either easy to avoid or easy to repair

The US Navy is proceeding with a programme allowing LASIK with IntraLase flap creation in naval aviators.

A rising number of phakic IOLs are steadily making their way into clinics, with each one offering its own unique property to set it apart from the competition. Documented studies will tout the benefits of each lens and, in many cases, will compare phakic lenses in head-to-head studies. Naturally, all studies are important and the benefits a particular kind of lens affords in a certain type of patient, is absolutely critical if a surgeon is to make an informed decision on his or her choice of lens. However, just as important as the choice of lens, is the surgical technique employed to implant the lens. A good technique will, amongst other things, reduce the incidence of potential complications that could ensue as a result of surgery and it will lead to a faster recovery time.

A new fixed combination of dexamethasone and netilmicin offers an effective and safe way to control ocular inflammation after cataract surgery.

Alcon has received FDA approval for the AcrySof ReSTOR intraocular lens (IOL) for the correction of aphakia following cataract surgery in patients with or without presbyopia.

Pre-soaked IOLs may provide an excellent way to deliver fourth-generation fluoroquinolones to prevent endophthalmitis.

Research into the remarkable workings of the human eye have led to the acknowledgement of the presence of inherent higher order aberrations (HOAs) of the cornea, such as coma and spherical aberration. These aberrations are known to lead to optical degradation with the most significant culprit being spherical aberration.

Refinements in lens technology have probably acted as the greatest catalyst for the recent upsurge in interest that has been witnessed in multifocal intraocular lenses (MIOLs). Coupled with the CE and FDA approvals of several second generation MIOLs, the number of refractive lens exchange (RLE) procedures that have been conducted in individuals over the age of 45 years seeking spectacle independence, has soared.

Although presbyLASIK is still, by no means, perfect, it seems to present a good solution for certain cases, particularly in myopes and hyperopes.