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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.

Events that have taken place in the market of contact lens hygiene and care products over the last two years give the impression that the hygiene scene is again in crisis. A crisis which is perhaps comparable with the "chlorhexidine shock" of almost three decades ago, which raised the question "is there a completely effective, safe and trouble-free way of caring for contact lenses?"

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 clinical assessment of an anterior chamber inflammatory reaction may be difficult to determine in eyes where corneal clarity is reduced by corneal oedema. Slit lamp examination is currently the gold standard method to assess inflammation1-3 but in conditions such as poor corneal clarity, the clinician routinely encounters difficulties.

Glaucoma gene identified

Researchers from the University of Iowa, USA have discovered that a gene and related signaling pathway play a role in the development of glaucoma.

A travoprost - travoprost/timolol (T-TT) treatment sequence is more effective at preventing the need for a third-line treatment than a latanoprost - latanoprost/timolol (L-LT) treatment sequence.

The Pulsair EasyEye non-contact tonometer (Keeler) can be considered an accurate and reliable method of measuring intraocular pressure (IOP) in the normotensive population but it cannot be used interchangeably with the Goldmann tonometer.

The side effects and complications associated with intravitreal bevacizumab (Avastin) are minimal and can be prevented, in most cases, by careful injection and good patient selection.

The da Vinci Surgical System (Intuitive Surgical) provides adequate dexterity for performing delicate intraocular manipulation, however, the kinematics of the robotic arms is insufficient for standard intraocular surgery.

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.

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

Deep sclerectomy with the SkGel implant (Corneal Laboratories) provides stable, long-term control of intraocular pressure (IOP) and visual field .

A study published online ahead of print by Diabetes Care has found that plasma total homocysteine concentration may be a useful biomarker and/or a novel risk factor for increased risk of diabetic retinopathy (DR) in people with type 2 diabetes.

The gene sFRPI plays a key role in glaucoma development, and researchers from the University of Iowa (UI) have found that an over-expression of the gene raises fluid pressure in the eyes.

Intravitreal triamcinolone acetonide (IVTA) for the treatment of steroid-responsive disorders of the posterior segment is associated with a low incidence of serious vision-threatening adverse events.

LASIK linked to depression

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

Progress in the diagnosis and treatment of retinoblastoma has been minimal over the past couple of decades, although improvements have been made, and new therapies are being studied, according to an ocular oncology expert.