Cataract & Refractive

Keratoconus progression was halted in all 20 eyes treated at eight months postoperatively. In 75% of eyes we recorded a regression in pathology and an improvement in visual acuity was seen in 80% of eyes

Marred by reports of vision loss due to contamination, amongst other complications, trypan blue has received its fair share of bad press over recent years, with many unapproved versions of the formulation making its way into cataract surgeons' practices.

As a result of our excellent postoperative patient data in a variety of applications, we will continue to use the femtosecond laser technology in our practice. It supports our procedures with great precision and safety, it is easy to use and enables us to set new standards in our surgeries

As described by Huang et al. more than a decade ago, optical coherence tomography (OCT) is a non-contact, non-destructive imaging modality that acquires depth-resolved two- and three-dimensional images of biological tissue.

PCO secondary cataract, no matter how you label it, it exists and it is the most common complication of cataract removal or extraction.

The popularity of phakic IOLs in both cataract and refractive surgery has soared in recent years with lens manufacturers all joining the race to develop better lenses with improved outcomes and fewer complications. Although phakic IOLs are considered the ideal tools for the correction of high ametropias, because of their excellent accuracy and predictability, stability of refraction from day one and independence of tissue healing, they have, unfortunately, been marred by reports of certain complications throughout their development history. These complications include corneal decompensation, chronic inflammation, iris atrophy (pupil distortion), cataract and glaucoma. Here, Ant?nio Marinho, MD, PhD discusses the influence of phakic IOLs on cataract and glaucoma development.

Globally, LASIK is a very popular refractive procedure, which provides excellent visual acuity and quality of vision in low to moderate myopia and hyperopia.1 In the mid-nineties, however, LASIK was performed even in extreme myopic errors (up to 23D) or in corneas that were too thin with or without Forme Fruste Keratoconus (FFKC).

Ophthalmology is a branch of medicine that we, as ophthalmologists, regard as an elite branch of medicine and others, such as general surgeons and physicians, often consider as a minor and sometimes easy discipline. As a result of this misdirected preconception, a general practitioner, consultant or physician may not feel it necessary to fully inform us of a patient's health record because they do not consider that ophthalmic medications could, potentially, carry with them serious, sometimes life threatening side effects, if used inappropriately.

DSAEK will soon replace conventional PK surgery for the treatment of endothelial decompensation

Didier Ducournau talks about the development and growth of the EVRS and on his personal vision for vitreoretinal surgeons.

Postoperative endophthalmitis is a rare but potentially devastating intraocular infection, which could lead to severe and permanent visual impairment or even the loss of an eye.1-3 With the average life expectancy on the increase, the prevalence of cataract in the older population and therefore the cataract surgical rate has increased in recent decades.1,3 Many have voiced their concerns that this rise in the number of surgical procedures could bring with it a rise in incidence of endophthalmitis, hence, evaluation of postoperative infection incidence is extremely important in every clinical setting.

CE marked in April of 2006, the KS-3Ai has become the first preloaded aspheric silicone IOL to be approved in Europe for use in cataract surgery. Although the product has yet to gain approval in the US market, it is already available in Japan and will shortly be entering clinics in Europe.

Wound distortion by manipulation of two rigid cannulas during bimanual phaco through tight corneal incisions has been shown to be significant.

Research, development, innovation and the quest for excellence go hand in hand with the evolution of the ophthalmology industry. With the new wave of phakic IOLs entering the market, each with its own unique offering and capabilities, it's hard to know which lenses will suit you and your patient best. Furthermore, does the introduction of these new refractive correctors threaten the position of the lasers that we have all come to grow to love? It seems that the laser refractive surgery industry is still going from strength to strength.

IOL implantation in older, cataract patients often fails to enhance vision to a level that is greater than that of the average non-cataractous lens of a similar age.

Surgeons should not feel ashamed if they only manage to see a few patients, devotion to the patient and then to your practice is of paramount importance. Then, and only then, will you be doing your job well.

Results of a study evaluating post-cataract surgery endophthalmitis at a regional tertiary referral centre in England show no evidence of an increase in incidence over a recent period of almost eight years, reported Omar M. Durrani, FRCS.

The corneal endothelium is able to function adequately, even after losing a large number of endothelial cells.

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.

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.

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.

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

Accommodative lenses on the whole are showing significant promise and have certain advantages over multifocal IOLs because they do not have different refractive zones, contrast or glare problems

Anterior chamber angle-supported phakic intraocular lenses have now become a viable alternative for the correction of moderate and high refractive errors with excellent levels of efficacy, predictability and safety.

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.

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.

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

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

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.