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Refractive lens exchange has become the procedure of choice for correcting high ametropia in the presbyopic patient. From the refractive surgeon's perspective, the AcrySof? ReSTOR? lens is a wonderful option for refractive lens exchange. It is safest in eyes without high or excessive axial length. Until recently, the only implants available for refractive lens exchange were monofocal intraocular lenses (IOLs). These provided patients with a single focal point, either for reading or for distance. The Array? multifocal IOL became available several years ago, but my experience, and the collective experience of many other surgeons, was that this zonal refractive, multifocal IOL did not provide a satisfactory result for most patients.

Robert J. Cionni, MD

The surprising outcomes of the European Glaucoma Prevention Study (EGPS) can be accounted for by a number of explanations and should not be interpreted as meaning that lowering IOP has no benefit for glaucoma, said Harry A. Quigley, MD.

I often feel that the European ophthalmology industry is becoming the victim of its own success. With the half-life value of ophthalmic knowledge on the continent now set at less than five years, compared with 30 years in 1960, innovation in Europe is not showing any signs of slowing down. Ophthalmologists in Europe are continuously required to update and broaden their specialist knowledge with the advent of new techniques, treatments, instruments and devices. With meetings every few weeks, around the globe, on all branches of ophthalmic science and clinical practice, how is it possible to keep up?

Are you aware of all of the ophthalmology societies that operate around Europe? Do you know what they strive to achieve, how they came to be, who their key figureheads are, for example? You are probably familiar with some of the ophthalmology societies that are out there in Europe, but maybe not so familiar with what they're up to.

Despite recent advances and the promise of new therapies for the treatment of choroidal neovascularization (CNV) resulting from age-related macular degeneration (wet AMD), key challenges remain. These include improving vision outcomes, reducing the numbers of treatments and proving efficacy in different lesion types. While treatment for wet AMD has traditionally centred on monotherapy regimens, the future standard of care may likely focus on combination strategies.

1991 witnessed the birth of the European Society of Cataract and Refractive Surgeons (ESCRS); a new kind of society aimed at unifying specialists and societies across a number of disciplines throughout the continent. Society President, Professor Marie José Tassignon talks to OTE about her vision for the future.

The FDA has denied Genentech's request to fast-track the application for its age-related macular degeneration (AMD) agent, Lucentis (ranibizumab). In response, Genentech announced it plans to file a complete Biologics License Application (BLA) for Lucentis for the treatment of neovascular AMD in December 2005, in a bid to speed up the process. Although the FDA rejected Genentech's request for fast-track designation, this should not affect the timing for BLA submission or the potential to obtain priority review.

With lengthening follow-up, the posterior chamber ICL (STAAR Surgical) continues to be associated with encouraging results in the management of refractive amblyopia in children who have failed conventional therapy with contact lenses or spectacles, said Laurence C. Lesueur, MD.

Combination treatment of neovascular age-related macular degeneration (AMD) using verteporfin photodynamic therapy (Visudyne PDT, Novartis/QLT Inc.) plus intravitreal triamcinolone acetonide appears to improve visual outcomes and reduce the number of re-treatments necessary to achieve lesion regression compared with standard PDT alone, albeit with the recognized steroid-associated risks of cataract progression and IOP elevation, said Albert J. Augustin, MD, at the annual meeting of the American Society of Retina Specialists.

Coaxial microphacoemulsification performed through a 2.2 mm incision is a new technique available to cataract surgeons skilled in phacoemulsification. The technique affords patients the combined benefits of ultra-small incision surgery and conventional foldable IOLs, announced Robert H. Osher, MD, professor of ophthalmology, University of Cincinnati College of Medicine, and medical director emeritus, Cincinnati Eye Institute, Cincinnati, Ohio, USA.

Having read, written and reviewed a number of papers and manuscripts on corneal transplantation, I have found that, in certain cases, conclusions that are drawn relating to the best trephination/suturing technique or concerning the best concept to avoid immunologic graft rejections, are not adequately supported by the study results. This often leads me to question the validity and value of these reports.

Approved by the FDA in March 2005 for use in cataract patients with or without presbyopia, Alcon's AcrySof ReSTOR lens is the first apodized diffractive intraocular lens (IOL) to be made available. The approval was granted based on clinical trials which found that patients experienced the highest level of freedom from glasses ever achieved in IOL clinical trials.

"Smoking increases your risk of developing blindness" is the shocking message being transmitted across the UK in a bid to raise awareness.

Major advances have been made in the understanding of the pathogenesis of posterior capsule opacification (PCO) post-cataract surgery, and improvements in surgical technique and lens biocompatibility and design have reduced the rates of opacification in recent years. Nonetheless, opacification remains an important complication in patients undergoing phacoemulsification or extracapsular cataract extraction combined with intraocular lens (IOL) placement, with approximately up to 25% of patients developing visually significant PCO during the first five years post surgery.

Epi-LASIK combines the advantages of both LASEK and LASIK while minimizing the disadvantages of each

Coaxial microphacoemulsification performed through a 2.2 mm incision is a new technique available to cataract surgeons skilled in phacoemulsification. The technique affords patients the combined benefits of ultra-small incision surgery and conventional foldable IOLs, announced Robert H. Osher, MD, professor of ophthalmology, University of Cincinnati College of Medicine, and medical director emeritus, Cincinnati Eye Institute, Cincinnati, Ohio, USA.

Investigators caused a stir at the 23rd Annual Meeting of the American Society of Retina Specialists (ASRS) in Montreal, Canada, when they hinted at a potential use of bevacizumab (Avastin) in neovascular age-related macular degeneration (neovascular AMD).

The FDA has given its approval for Advanced Medical Optics' (AMO) Tecnis foldable acrylic intraocular lens (IOL) for reduced spherical aberration and improved functional vision in cataract patients.

The fundamental issue of wound integrity has dissuaded me from pursuing further research and development of this technique

The formation of Elschnig pearls is a highly dynamic process and is detectable even over very short time intervals. Elschnig pearls can appear or disappear within one day, according to Oliver Findl, MD, from the Medical University of Vienna, Austria.

Surgery vs conservative management of strabismus

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In a night-driving simulation, fog and glare separately reduced sign recognition distances but when combined paradoxically increased performance relative to either factor alone. However, fog and glare reduced object recognition both separately and when paired, said Bruce A. Drum, PhD, Division of Ophthalmic and ENT Devices, FDA, Rockville, MD.