ESCRS 2007

All the news from the XXV Congress of the European Society of Cataract and Refractive Surgery, held September 8–12 2007 in Stockholm, Sweden.

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DateDay One |  Day Two |  Day Three |  Day Four

TypeIndustry or Product news |  Scientific news

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Day One: 8 September 2007

Aspheric IOLs: customising the selection processIt is possible to select aspheric intraocular lenses (IOLs) based on preoperative corneal spherical aberration (SA), according to Mark Packer and colleagues from the Oregon Eye Institute, USA. 

Customized IOLs: stability mattersWhen it comes to correcting spherical aberration (SA) of the whole eye, customized IOLs could be a possible approach for the future. 

Careful preop preparation minimizes explantationCareful patient selection and precise biometry will all help minimize the risk of later explantation of multifocal IOLs, Dr Risto Uusitalo of the Helsinki Eye Clinic said. 

Avastin useful adjunct for glaucoma therapyAvastin (bevacizumab) is a useful adjunct for the treatment of neovascular glaucoma, but it is too soon to say if it will have a long-term impact on glaucoma therapy, according to Dr Stefan Scholl. 

Multifocals good choice for right patientMultifocal intraocular lenses (IOLs) are a good choice for the right patient, according to Dr Martin Leyland of the Royal Berkshire Hospital, presenting the third update of the Cochrane systemic review of multifocal vs. monofocal studies. 

Schwind showcases new excimer laserThree years of research and development paid off today when Schwind eye-tech-solutions unveiled the Schwind AMARIS excimer laser to the refractive surgery community. 

B&L launches Stellaris Vision Enhancement SystemBausch & Lomb (B&L) today launched its new Stellaris Vision Enhancement system, further demonstrating its dedication to its microincision cataract surgery franchise. 

PRK with MMC as good as LASIKWavefront-guided photorefractive keratectomy (PRK) with mitomycin C (MMC) offers very similar results, when correcting compound myopic astigmatism, to wavefront-guided LASIK surgery, according to Mauro Campos and colleagues from the Federal University of São Paolo, Brazil. 

Informed consent menuPatients should be offered a "menu" of options regarding what level of discussion takes place prior to cataract surgery, according to Michael Austin and co-workers from two hospitals in South West Wales, UK. 

Dual optic accommodating IOL offers good quality of lifeDual optic accommodating IOLs provide a more noticeable positive impact on a patient's quality of life than multifocal IOLs, according to Andrea Galvis and Ivan Ossma of the Instituto para Ninos Ciegos y Sordos, Columbia. 

LASIK induces irregular astigmatismUnlike LASEK, LASIK significantly increases irregular astigmatism in the 3 and 5 mm central zones, according to Liliana Voinea and co-workers from the Optilaser Medical Center, Bucharest, Romania. 

Mix and match = better patient satisfactionMixing and matching the ReZoom (AMO) and Tecnis (AMO) multifocal intraocular lenses (IOLs) produces enhanced visual outcomes and patient satisfaction, according to Baha Toygar and colleagues from the Dunya Eye Hospital, Istanbul, Turkey. 

Adapt AO outperforms conventional lensAt one-year follow-up, the aspheric Akreos Advanced Optics (Adapt AO; Bausch & Lomb) intraocular lens (IOL) achieves better high contrast uncorrected and best corrected visual acuity (UCVA & BCVA) than the conventional spherical Akreos Adapt IOL, according to Ann Haustermans, Belgium. 

Take the omni-focal approachAn omni-focal approach, combining an aspheric presbyopic treatment with a hyperopic ablation, looks promising as a method for improving near vision in hyperopes with presbyopia, according to Efekan Coskunseven from the Dunya Eye Hospital, Istanbul, Turkey. 

Three multifocals: similar resultsThe multifocal ReSTOR (Alcon), Tecnis multifocal (AMO) and *Acri.LISA (Acri.Tec) lenses can all provide satisfactory distance and near uncorrected vision, according to Pascal Rozot and colleagues from the Clinique Monticelli, Marseille and Paris, France. 

Aspherical lenses = fewer aberrationsThe incidence of spherical aberrations tends to be lower in eyes with aspherical lenses than in eyes with spherical lenses, according to Paolo Garimoldi and colleagues from the Ospedale di Circolo, Italy. 

ALTK & DSAEK offer fast visual recoveryAutomated lamellar therapeutic keratoplasty (ALTK) and Descemet stripping automated endothelial keratoplasty (DSAEK) are both safe and effective techniques for corneal transplantation, according to Paolo Garimoldi and colleagues from Ospedale di Circolo, Italy. 

IOLs as drug delivery devices: the future for antibiotic provision?Antibiotic-soaked IOLs could present a viable alternative to topical antibiotics for surgeons wanting to provide a sustained release of antibiotic in cataract patients, according to Randall Olson, MD, Presidential Professor and Chair of the Department of Ophthalmology and Visual Sciences at the John A. Moran Eye Center, Salt Lake City, Utah, USA. 

SICS: effective solution to a huge cataract problemSmall incision cataract surgery (SICS) is a highly desirable and effective technique for India and other countries in the eastern hemisphere because it provides a highly effective and economic treatment for the vast cataract population in that part of the world, said Dr Satyajit Sinha of the AB Eye Institute, Patma, India. 

Intracameral mydriatic delivery: simplifying the processIntracameral mydriatic delivery greatly simplifies cataract surgery, according to Anders Behndig and colleagues from Umeå University Hospital, Sweden, speaking at the update on drug delivery systems symposium. 

Foldable IOLs: dislocation most common explant causeDislocation and decentration are, overall, the most common reasons for foldable intraocular lens (IOL) explantation, and the incidence of these complications is rising, said Nick Mamalis, MD of the John Moran Centre, University of Utah, USA. 

Patient attitude influences perceived satisfactionThe psychological outlook of patients has enormous influence on their perception of quality of life after cataract surgery, even if the outcome is poor, said Oliver Findl, MD of Moorfields Eye Hospital, London, UK. 

Day Two: 9 September 2007

Avastin: a new hope for corneal transplant patients?Topical bevacizumab (Avastin) has shown excellent preliminary results and good topical tolerance when used in the prevention of corneal transplant failure, according to Jose Güell and Merce Morral, from Instituto de Microcirugía Ocular (IMO) de Barcelona, Spain, speaking at "The endothelium: new surgical and medical concepts" symposium. 

Defect technology: a new horizon in endothelium transplantationGene defect technology can be used to prevent corneal allograft rejection and the decay of endothelial cells in ex vivo corneal transplantation, according to Dr Frank Larkin of Moorfields Eye Hospital in London, UK. 

Microincision prelex yields impressive visual resultsExcellent visual results can be obtained with microincision prelex in selected patients bilaterally implanted with the Acri.Lisa lens (Acri.Tec) through a 1.5 mm incision and combined with astigmatic surgery when needed, said Dr Dominique Pietrini, of the Clinique de la Vision in France. 

Toric IOLs good choice to correct astigmatismResidual astigmatism plays an important role in the quality of visual outcome after cataract surgery, so astigmatism correction must be targeted during cataract surgery. This is especially relevant in cases over 3 D of corneal astigmatism, said Jorge Alió, MD at the Acri.Tec symposium. 

Schwind Amaris: already providing excellent resultsSchwind eye-tech-solution's latest unveiling, the SCHWIND AMARIS excimer laser, provides excellent visual acuity results, high predictability and low variance in results, according to Maria-Clara Arbelaez, MD from Oman, speaking at the Schwind lunchtime symposium. 

New *Acri.Tec monotoric bifocal lens takes to the stageContinuing on the path of IOL innovation, *Acri.Tec today unveiled the latest offering from its family of lenses in the form of the monotoric bifocal Acri.LISA Toric 466 TD lens. 

WaveLight unveils new generation microkeratomeWaveLight today raised the curtain on its fine-tuned, new generation microkeratome, RONDO. 

OccuLogix completes patient enrolment for glaucoma laser trialOccuLogix today announced the completion of enrolment for the SOLX 790 titanium laser trabeculoplasty (TLT) clinical trial, which the firm hopes will support its application for 510(k) clearance with the FDA. 

Hydrophobic lenses produce less PCO than hydrophilic lensesPatients implanted with a hydrophilic intraocular lens (IOL) develop more posterior capsule opacification (PCO) and have worse visual acuity (VA), contrast sensitivity and glare after two years, compared with patients implanted with a hydrophobic IOL, according to Charlotta Zetterström and colleagues of St Erik's Eye Hospital, Stockholm, Sweden. 

CCT measurements a must for all glaucoma patientsCentral corneal thickness (CCT) measurements should be carried out on all glaucoma patients in order to help set an accurate target intraocular pressure (IOP) range, according to Madhu Nagar and colleagues from the Clayton Hospital, West Yorkshire, UK. 

LASIK is safe even in high-risk patientsLong-term follow-up has demonstrated that LASIK is a safe procedure even in high risk, highly myopic eyes, according to Patrick Condon and colleagues from the Waterford Eye Specialists, Dublin, Ireland and the Gordon Binder Vision Centre, USA. 

Temporary pupil rings useful in complicated MICSThe use of temporary pupil rings for pupil dilation during microincision cataract surgery (MICS) is particularly useful in cases with floppy iris syndrome, according to Boris Malyugin from the S. Fyodorov Eye Microsurgery Complex, Moscow, Russia. 

Non-penetrating filtering surgery with MMCNon-penetrating filtering surgery with intraoperative mitomycin C (MMC) and without a scleral implant, can provide reasonable intraocular pressure (IOP) control, according to Esther Arranz-Marquez and co-workers from the Vissum Corporacion Oftalmologica de Madrid, Spain. 

Toric implantable collamer lens offers good resultsImplanting the Toric Implantable Collamer Lens (TICL; STAAR Surgical) to correct various degrees of myopia and compound myopic astigmatism, produces predictable refractive results, according to Daniel Elies from the Institut Oftalmologic Integral, Barcelona, Spain. 

LASIK could now be possible in patients previously excludedEpithelial thickness profiles may make it possible for LASIK to be performed in eyes that may otherwise have been excluded because of topographic suspect keratoconus, according to Dan Reinstein and colleagues from the London Vision Clinic, London, UK. 

Customized ablations following IOL implantation = spectacle independenceFollowing enhancement with IntraLase bioptics, nearly all patients with high preoperative astigmatism can achieve spectacle independence, according to Michael Knorz from the University Hospital, Mannheim, Germany. 

Iris retractors useful in small pupil surgeryIris retractors are a safe and useful addition to small pupil phacoemulsification, according to Arup Chakrabarti and colleagues from the Chakrabarti Eye Care Centre, India. 

Epithelium removal not necessary for collagen cross-linkingCorneal collagen cross-linking with riboflavin, without removing the epithelium, is both safe and effective, according to Roberto Pinelli, ILMO, Brescia, Italy. 

Refraction following PRK stable over eight yearsPostoperative refraction following photorefractive keratectomy (PRK) remains stable from the second year postoperatively through to eight years, according to Hossein Mohammad Rabei and colleagues from the Basir Eye Center, Tehran, Iran. 

Combined procedure for PEXG and cataractCombined phacoemulsification and viscocanalostomy achieves excellent intraocular pressure (IOP) control and improves visual acuity (VA) in patients with co-existing cataract and pseudoexfoliation glaucoma (PEXG), according to Mohammed Awadalla and colleagues from Saudi Arabia. 

DXEK has direct effect on corneal hysteresis & biomechanicsDescemetorhexis with endokeratoplasty (DXEK) has a direct effect on corneal hysteresis and the biomechanical properties of the human cornea, according to Thomas John and colleagues from Loyola University, Chicago, USA. 

Visian ICL: a viable alternative to corneal refractive surgery?In the treatment of myopia, STAAR Surgical's Visian ICL (Implantable Collamer Lens) is a preferable alternative to corneal refractive surgery, according to a panel of experts speaking at the STAAR Surgical symposium. 

Day Three: 10 September 2007

Endophthalmitis: sterile unit cefuroxime dose neededIf a sterile unit dose of cefuroxime were available it would become the world standard for endophthalmitis prophylaxis following the startling proof of its efficacy in the ESCRS endophthalmitis study last year. That was the conclusion of a debate for and against intracameral antibiotics at the JCRS Symposium, Controversies in Cataract & Refractive Surgery. 

Pentacam an excellent device with limitationsThe Pentacam (Oculus) is an excellent device, but it has limitations, the audience heard during a debate of the system's pros and cons in corneal diagnosis at the JCRS Symposium, Controversies in Cataract & Refractive Surgery. 

Refractive surgery will disappear to be replaced by RLEDr Howard I. Fine told delegates that he was the best ophthalmic surgeon because none of his patients used glasses. He then showed the audience a video of 'patients', all wearing spectacles, drinking directly from bottles of wine. It was a light finish in keeping with the session's theme, "I am the best because…". 

Microcoaxial torsional phaco method of choiceThe vast majority of ophthalmologists are going to become convinced that 2.2 mm microcoaxial surgery with Ozil (Alcon) phaco must be the method of choice for both surgeons and patients said Dr Robert Osher. 

SLT the number one choice for first-line treatmentSelective laser trabeculoplasty (SLT) is an effective method of long-term treatment for glaucoma, according to Madhu Nagar of the Clayton Eye Centre, UK. 

Glaucoma management: SLT on trialThe use of selective laser trabeculoplasty (SLT) in the management of glaucoma is a safe and effective treatment method, according to Shlomo Melamed from the Sam Rothbery Glaucoma Centre in Tel Aviv, Israel, speaking at the Ellex symposium. 

AMO announces expansion of refractive portfolioAMO today announced the introduction of three new refractive technologies to the European market: the Tecnis 1-piece intraocular lens (IOL), the Tecnis multifocal acrylic IOL and the WhiteStar Signature phaco system. 

Zeiss showcases latest innovationsZeiss took advantage of the annual European congress to announce some product debuts and technological enhancements to currently marketed products. 

Surgeon recommends firms manufacture IOLs in 0.25 D stepsIt would be helpful if IOL manufacturers made lenses available in 0.25 D steps and provided more detailed information regarding the optical design since refractive outcomes can now be predicted more accurately, according to Thomas Olsen from the University Eye Clinic, Aarhus Hospital, Denmark. 

CustomVue offers good results in mixed astigmatismExcellent visual outcomes can be achieved in subjects with mixed astigmatism when using the VISX wavefront platform's CustomVue iris registration system (AMO), according to Baha Toygar and co-workers from the Dunya Eye Hospital, Istanbul, Turkey. 

A few simple changes can reduce endophthalmitis dramaticallyChanges to perioperative management of cataract patients, including the use of disposable bimanual irrigation/aspiration handpieces, intracameral cefuroxime and povidone iodine wash can be effective in reducing the instances of endophthalmitis, according to Richard Packer from the King Edward VII Hospital, Windsor, UK. 

ReSTORing good visionThe diffractive AcrySof ReSTOR (Alcon) intraocular lens (IOL) can provide stable, high levels of spectacle independence for both near and distance vision, according to Rudy Nuijts and colleagues from the Academic Hospital Maastricht, The Netherlands. 

Corneal ring segments proving their worthFerrara corneal rings are a useful tool in the treatment of keratoconus but long-term stability still needs to be established, according to Akef El Maghraby and colleagues from the Magrabi Eye and Ear Center, Jeddah, Saudi Arabia. 

Three lenses go head-to-headThe implantation of multifocal and accommodative intraocular lenses (IOLs) can offer adequate near and far vision in addition to high levels of patient satisfaction, according to Georgio Marchini and colleagues from the University of Verona, Italy. 

Combining ring segments and cross-linking yields good resultsImplantation of intracorneal ring segments (ICR) can be combined with a UV cross-linking procedure, according to Omid Kermani and colleagues from a private eye clinic in Schildergasse, Germany. 

90 micron flaps get the thumbs upUsing a femotsecond laser (IntraLase) to create flaps of 90 microns does not increase the postoperative risk of striae formation or induction of optical aberrations, according to Omid Kermani and colleagues from Augenklinik am Neumarkt, Cologne, Germany. 

Contrast performance best with zero spherical aberrationsBy using adaptive optics and physiological eye models, Pablo Artal and colleagues from Universidad de Murcia, Spain have determined that contrast performance peaks when spherical aberration is completely corrected. 

Bacteria building resistance to moxifloxacinAlthough moxifloxacin has excellent antibacterial coverage, there is an emergence of a resistance to it in bacteria isolated from corneal ulcers, according to Gita Sathpathy and co-workers at the All India Institute of Medical Sciences, New Dehli, India. 

A new concept: treating corneal amblyopia with corneal wavefront guided LASIKCases of amblyopia should undergo corneal wavefront analysis and would benefit from corneal wavefront-linked LASIK, according to Cyres and Keiki Mehta from the Mehta International Eye Institute and Supervision Laser Center, Mumbai, India. 

Akreos MICS lens gets the thumbs upCataract surgery with the Akreos MI60 microincision lens (Bausch & Lomb) is a safe and effective procedure, according to Jorge Alió and co-workers from VISSUM Instituto Oftalmologica de Alicante, Spain and study groups in France, Germany, Italy and Sweden. 

Cell loss no greater with femtosecond lasersPenetrating keratoplasty (PK) with a femtosecond laser offers good surgical results and endothelial cell loss numbers similar to those found for PK using standard trephines, according to Mike Holzer and co-workers at the International Vision Correction Research Centre, Heidelberg University, Germany. 

Acrylic lenses produce virtually no PCOThe new acrylic *Acri.Lyc 356 (*Acri.Tec) diffractive intraocular lens (IOL) produces practically no posterior capsule opacification (PCO) compared with its silicone counterpart, according to Filippo Simona from the LaserVis Refractive Centre, Locarno, Switzerland. 

LADAR 6000: good but time consumingAlthough the LADAR 6000 (Alcon) is accurate and safe, the need for pharmacological mydriasis and the use of a nomogram result in a more time consuming surgical procedure, according to Joaquim Murta and colleagues from Coimbra University, Portugal. 

LASIK & PRK: still looks good ten years onLASIK for myopia over -10 D is a safe procedure; myopic regression slows down with time and there is a high rate of best spectacle corrected visual acuity (BSCVA) increase in the long-term, according to Jorge Alió, MD and colleagues from the VISSUM Instituto Oftalmológico de Alicante and the Miguel Hernandez University Medical School, Spain. 

Zooming in on the implantable telescopeA long-term Phase II/III study (IMT002) of an implantable telescope prosthesis for end-stage macular degeneration has demonstrated that it can improve quality of life and sustain visual acuity (VA) improvements, according to Mark Packer, one of the trial investigators from the USA. 

Staged IOL implantation = happy patientsBy employing staged implantation of intraocular lenses (IOLs), surgeons can produce the best possible visual outcomes for each individual patient, according to Richard Lindstrom from Minnesota, USA. 

Day Four: 11 September 2007

IOL type determines complications in phakic surgeryThe type of phakic IOL chosen strongly governs the type of complication that is likely to occur in the long-term. Posterior, angle-supported anterior and iris supported anterior phakic IOLs all have different issues that face the surgeon. 

Sulcoflex: a new IOL concept for the pseudophakic eyeThe new sulcoflex intraocular lens (IOL), which has been designed for sulcus-implantation in the pseudophakic eye ("piggy back"), is safe and well-tolerated, according to Michael Amon, MD from the University of Vienna Medical School, Austria. 

US and EU practice styles similarThe practice styles and choices of US and EU ophthalmologists are very similar with the greatest differences apparent in refractive surgery, David Leaming said. Dr Leaming revealed the results of the ESCRS/ASCRS comparison survey, which tracks practice choices in both societies. 

Preop and postop imaging vital for phakic IOLsPreop and postop imaging and endothelial cell counts are vital to check the position and performance of a phakic IOLs, Dr David Hardten told colleagues. 

Improving astigmatism correction with a rotation-stable, bitoric, aspherical IOL and coaxial MICSImplantation of the bitoric, aspherical intraocular lens (IOL), *Acri.Comfort 646 TLC (*Acri.Tec), is rotation-stable and associated with excellent levels of astigmatism correction in cataract patients, according to Detlev Breyer, a high volume surgeon of ZeitzBreyer-Augenheilkunde an den Schadow Arkaden in Dusseldorf, Germany. 

Fluoroquinolones: do not taper doseTapering the dose of a topical fluoroquinolone at the end of a course of treatment is a great way to build up bacterial resistance. As such, doctors must not taper the dosage at the end of treatment, according to Dr Richard L. Abbott. 

Amadeus II achieves precision in lamellar keratoplasty and epi-LASIKAmadeus II (Ziemer) achieves more precise corneal depth and faster epithelial healing time than other surface ablation treatments for lamellar keratoplasty and epi-LASIK, according to Carlo Lackerbauer from Munich, Germany, presenting at the Zeimer symposium. 

PRL offers good results for high myopiaImplantation of phakic refractive lenses (PRL) appears to be a predictable and well-tolerated procedure for correcting high myopia, according to Esther Arranz-Marquez and co-workers from Vissum Corporación Oftalmológica de Madrid, Spain. 

Visian ICL offers good long-term BSCVAOver a five-year follow-up period the Visian implantable collamer lens (ICL) (STAAR Surgical) maintains a good level of best spectacle corrected visual acuity (BSCVA), according to results from the US multicentre FDA study, as reported by John Vukich of Madison, Wisconsin, USA. 

Signature phaco machine offers good stabilityAnterior chamber fluctuations during phacoemulsification can cause an increase in retinal thickness and alterations of the blood aqueous barrier. In order to avoid these complications, it is better to use a machine that offers good anterior chamber stability, according to Alessandro Franchini and colleagues from the University of Florence, Italy. 

AcrySof toric IOL offers spectacle independenceThe AcrySof toric intraocular lens (IOL) (Alcon) offers greater spectacle independence than the monofocal AcrySof SA60AT single-piece IOL (Alcon), according to Paul Ernest from Jackson, USA. 

Aspheric ablation good for hyperopic presbyopesAspheric ablation is a good surgical option for enhancing near vision in hyperopic presbyopes, according to Marc Lafontaine and colleagues from the Canadian multicentre LASIK trial of aspheric treatments for the correction of hyperopic presbyopia. 

Subtenons anaesthesia more comfortable for photophobicsPatients who report photophobia prior to phacoemulsification may be more comfortable under subtenon anaesthesia, according to Alexander Ioannidis and colleagues from the Mid-Essex Hospitals NHS Trust, London, UK. 

Blue blocking IOLs are not the best optionUltraviolet (UV) and violet blocking intraocular lenses (IOLs) can provide protection from radiation and offer good quality of vision, however, blocking blue light can actually cause a loss in quality of vision, according to Alessandro Franchini and Eleonora Vaccari from the University of Florence, Italy. 

Microcoaxial phaco better than standard phacoMicrocoaxial phacoemulsification induces significantly less keratometric changes and provides better visual acuity than standard phacoemulsification, according to Seyed Javad Hashemian and colleagues from the Fajr Hospital & Negah Eye Hospital, Tehran, Iran. 

Cataract surgery-induced dry eye may not be a direct consequence of surgeryDry eye following cataract surgery may not be a direct result of the surgery but rather the surgery triggers symptoms in eyes with pre-existing sub-optimal tear properties, according to Waheeda Illahi and colleagues from BMEC, City Hospital, Birmingham, UK. 

Oval instruments ease bimanual cataract surgeryUsing oval choppers and needles during bimanual cataract surgery spares energy and maintains anterior chamber stability, according to Fernando Araujo-Gomes from the Clinica de Santo Antonio, Amadora, Portugal. 

CK improves near vision in post-LASIK and plano presbyopic eyesNearVision conductive keratoplasty (CK) (Refractec) offers a minimally invasive method of enhancing near vision in plano presbyopes and in post-LASIK eyes, according to the results of an FDA presbyopia study and a CK post-LASIK study, as presented by Marguerite McDonald of Tulane University School of Medicine, New Orleans, USA. 

News by type

Industry and Product news

Schwind showcases new excimer laserThree years of research and development paid off today when Schwind eye-tech-solutions unveiled the Schwind AMARIS excimer laser to the refractive surgery community. 

B&L launches Stellaris Vision Enhancement SystemBausch & Lomb (B&L) today launched its new Stellaris Vision Enhancement system, further demonstrating its dedication to its microincision cataract surgery franchise. 

Schwind Amaris: already providing excellent resultsSchwind eye-tech-solution's latest unveiling, the SCHWIND AMARIS excimer laser, provides excellent visual acuity results, high predictability and low variance in results, according to Maria-Clara Arbelaez, MD from Oman, speaking at the Schwind lunchtime symposium. 

New *Acri.Tec monotoric bifocal lens takes to the stageContinuing on the path of IOL innovation, *Acri.Tec today unveiled the latest offering from its family of lenses in the form of the monotoric bifocal Acri.LISA Toric 466 TD lens. 

WaveLight unveils new generation microkeratomeWaveLight today raised the curtain on its fine-tuned, new generation microkeratome, RONDO. 

OccuLogix completes patient enrolment for glaucoma laser trialOccuLogix today announced the completion of enrolment for the SOLX 790 titanium laser trabeculoplasty (TLT) clinical trial, which the firm hopes will support its application for 510(k) clearance with the FDA. 

AMO announces expansion of refractive portfolioAMO today announced the introduction of three new refractive technologies to the European market: the Tecnis 1-piece intraocular lens (IOL), the Tecnis multifocal acrylic IOL and the WhiteStar Signature phaco system. 

Zeiss showcases latest innovationsZeiss took advantage of the annual European congress to announce some product debuts and technological enhancements to currently marketed products. 

US and EU practice styles similarThe practice styles and choices of US and EU ophthalmologists are very similar with the greatest differences apparent in refractive surgery, David Leaming said. Dr Leaming revealed the results of the ESCRS/ASCRS comparison survey, which tracks practice choices in both societies. 

Scientific news

Aspheric IOLs: customising the selection processIt is possible to select aspheric intraocular lenses (IOLs) based on preoperative corneal spherical aberration (SA), according to Mark Packer and colleagues from the Oregon Eye Institute, USA. 

Customized IOLs: stability mattersWhen it comes to correcting spherical aberration (SA) of the whole eye, customized IOLs could be a possible approach for the future. 

Careful preop preparation minimizes explantationCareful patient selection and precise biometry will all help minimize the risk of later explantation of multifocal IOLs, Dr Risto Uusitalo of the Helsinki Eye Clinic said. 

Avastin useful adjunct for glaucoma therapyAvastin (bevacizumab) is a useful adjunct for the treatment of neovascular glaucoma, but it is too soon to say if it will have a long-term impact on glaucoma therapy, according to Dr Stefan Scholl. 

Multifocals good choice for right patientMultifocal intraocular lenses (IOLs) are a good choice for the right patient, according to Dr Martin Leyland of the Royal Berkshire Hospital, presenting the third update of the Cochrane systemic review of multifocal vs. monofocal studies. 

PRK with MMC as good as LASIKWavefront-guided photorefractive keratectomy (PRK) with mitomycin C (MMC) offers very similar results, when correcting compound myopic astigmatism, to wavefront-guided LASIK surgery, according to Mauro Campos and colleagues from the Federal University of São Paolo, Brazil. 

Informed consent menuPatients should be offered a "menu" of options regarding what level of discussion takes place prior to cataract surgery, according to Michael Austin and co-workers from two hospitals in South West Wales, UK. 

Dual optic accommodating IOL offers good quality of lifeDual optic accommodating IOLs provide a more noticeable positive impact on a patient's quality of life than multifocal IOLs, according to Andrea Galvis and Ivan Ossma of the Instituto para Ninos Ciegos y Sordos, Columbia. 

LASIK induces irregular astigmatismUnlike LASEK, LASIK significantly increases irregular astigmatism in the 3 and 5 mm central zones, according to Liliana Voinea and co-workers from the Optilaser Medical Center, Bucharest, Romania. 

Mix and match = better patient satisfactionMixing and matching the ReZoom (AMO) and Tecnis (AMO) multifocal intraocular lenses (IOLs) produces enhanced visual outcomes and patient satisfaction, according to Baha Toygar and colleagues from the Dunya Eye Hospital, Istanbul, Turkey. 

Adapt AO outperforms conventional lensAt one-year follow-up, the aspheric Akreos Advanced Optics (Adapt AO; Bausch & Lomb) intraocular lens (IOL) achieves better high contrast uncorrected and best corrected visual acuity (UCVA & BCVA) than the conventional spherical Akreos Adapt IOL, according to Ann Haustermans, Belgium. 

Take the omni-focal approachAn omni-focal approach, combining an aspheric presbyopic treatment with a hyperopic ablation, looks promising as a method for improving near vision in hyperopes with presbyopia, according to Efekan Coskunseven from the Dunya Eye Hospital, Istanbul, Turkey. 

Three multifocals: similar resultsThe multifocal ReSTOR (Alcon), Tecnis multifocal (AMO) and *Acri.LISA (Acri.Tec) lenses can all provide satisfactory distance and near uncorrected vision, according to Pascal Rozot and colleagues from the Clinique Monticelli, Marseille and Paris, France. 

Aspherical lenses = fewer aberrationsThe incidence of spherical aberrations tends to be lower in eyes with aspherical lenses than in eyes with spherical lenses, according to Paolo Garimoldi and colleagues from the Ospedale di Circolo, Italy. 

ALTK & DSAEK offer fast visual recoveryAutomated lamellar therapeutic keratoplasty (ALTK) and Descemet stripping automated endothelial keratoplasty (DSAEK) are both safe and effective techniques for corneal transplantation, according to Paolo Garimoldi and colleagues from Ospedale di Circolo, Italy. 

IOLs as drug delivery devices: the future for antibiotic provision?Antibiotic-soaked IOLs could present a viable alternative to topical antibiotics for surgeons wanting to provide a sustained release of antibiotic in cataract patients, according to Randall Olson, MD, Presidential Professor and Chair of the Department of Ophthalmology and Visual Sciences at the John A. Moran Eye Center, Salt Lake City, Utah, USA. 

SICS: effective solution to a huge cataract problemSmall incision cataract surgery (SICS) is a highly desirable and effective technique for India and other countries in the eastern hemisphere because it provides a highly effective and economic treatment for the vast cataract population in that part of the world, said Dr Satyajit Sinha of the AB Eye Institute, Patma, India. 

Intracameral mydriatic delivery: simplifying the processIntracameral mydriatic delivery greatly simplifies cataract surgery, according to Anders Behndig and colleagues from Umeå University Hospital, Sweden, speaking at the update on drug delivery systems symposium. 

Foldable IOLs: dislocation most common explant causeDislocation and decentration are, overall, the most common reasons for foldable intraocular lens (IOL) explantation, and the incidence of these complications is rising, said Nick Mamalis, MD of the John Moran Centre, University of Utah, USA. 

Patient attitude influences perceived satisfactionThe psychological outlook of patients has enormous influence on their perception of quality of life after cataract surgery, even if the outcome is poor, said Oliver Findl, MD of Moorfields Eye Hospital, London, UK. 

Avastin: a new hope for corneal transplant patients?Topical bevacizumab (Avastin) has shown excellent preliminary results and good topical tolerance when used in the prevention of corneal transplant failure, according to Jose Güell and Merce Morral, from Instituto de Microcirugía Ocular (IMO) de Barcelona, Spain, speaking at "The endothelium: new surgical and medical concepts" symposium. 

Defect technology: a new horizon in endothelium transplantationGene defect technology can be used to prevent corneal allograft rejection and the decay of endothelial cells in ex vivo corneal transplantation, according to Dr Frank Larkin of Moorfields Eye Hospital in London, UK. 

Microincision prelex yields impressive visual resultsExcellent visual results can be obtained with microincision prelex in selected patients bilaterally implanted with the Acri.Lisa lens (Acri.Tec) through a 1.5 mm incision and combined with astigmatic surgery when needed, said Dr Dominique Pietrini, of the Clinique de la Vision in France. 

Toric IOLs good choice to correct astigmatismResidual astigmatism plays an important role in the quality of visual outcome after cataract surgery, so astigmatism correction must be targeted during cataract surgery. This is especially relevant in cases over 3 D of corneal astigmatism, said Jorge Alió, MD at the Acri.Tec symposium. 

Hydrophobic lenses produce less PCO than hydrophilic lensesPatients implanted with a hydrophilic intraocular lens (IOL) develop more posterior capsule opacification (PCO) and have worse visual acuity (VA), contrast sensitivity and glare after two years, compared with patients implanted with a hydrophobic IOL, according to Charlotta Zetterström and colleagues of St Erik's Eye Hospital, Stockholm, Sweden. 

CCT measurements a must for all glaucoma patientsCentral corneal thickness (CCT) measurements should be carried out on all glaucoma patients in order to help set an accurate target intraocular pressure (IOP) range, according to Madhu Nagar and colleagues from the Clayton Hospital, West Yorkshire, UK. 

LASIK is safe even in high-risk patientsLong-term follow-up has demonstrated that LASIK is a safe procedure even in high risk, highly myopic eyes, according to Patrick Condon and colleagues from the Waterford Eye Specialists, Dublin, Ireland and the Gordon Binder Vision Centre, USA. 

Temporary pupil rings useful in complicated MICSThe use of temporary pupil rings for pupil dilation during microincision cataract surgery (MICS) is particularly useful in cases with floppy iris syndrome, according to Boris Malyugin from the S. Fyodorov Eye Microsurgery Complex, Moscow, Russia. 

Non-penetrating filtering surgery with MMCNon-penetrating filtering surgery with intraoperative mitomycin C (MMC) and without a scleral implant, can provide reasonable intraocular pressure (IOP) control, according to Esther Arranz-Marquez and co-workers from the Vissum Corporacion Oftalmologica de Madrid, Spain. 

Toric implantable collamer lens offers good resultsImplanting the Toric Implantable Collamer Lens (TICL; STAAR Surgical) to correct various degrees of myopia and compound myopic astigmatism, produces predictable refractive results, according to Daniel Elies from the Institut Oftalmologic Integral, Barcelona, Spain. 

LASIK could now be possible in patients previously excludedEpithelial thickness profiles may make it possible for LASIK to be performed in eyes that may otherwise have been excluded because of topographic suspect keratoconus, according to Dan Reinstein and colleagues from the London Vision Clinic, London, UK. 

Customized ablations following IOL implantation = spectacle independenceFollowing enhancement with IntraLase bioptics, nearly all patients with high preoperative astigmatism can achieve spectacle independence, according to Michael Knorz from the University Hospital, Mannheim, Germany. 

Iris retractors useful in small pupil surgeryIris retractors are a safe and useful addition to small pupil phacoemulsification, according to Arup Chakrabarti and colleagues from the Chakrabarti Eye Care Centre, India. 

Epithelium removal not necessary for collagen cross-linkingCorneal collagen cross-linking with riboflavin, without removing the epithelium, is both safe and effective, according to Roberto Pinelli, ILMO, Brescia, Italy. 

Refraction following PRK stable over eight yearsPostoperative refraction following photorefractive keratectomy (PRK) remains stable from the second year postoperatively through to eight years, according to Hossein Mohammad Rabei and colleagues from the Basir Eye Center, Tehran, Iran. 

Combined procedure for PEXG and cataractCombined phacoemulsification and viscocanalostomy achieves excellent intraocular pressure (IOP) control and improves visual acuity (VA) in patients with co-existing cataract and pseudoexfoliation glaucoma (PEXG), according to Mohammed Awadalla and colleagues from Saudi Arabia. 

DXEK has direct effect on corneal hysteresis & biomechanicsDescemetorhexis with endokeratoplasty (DXEK) has a direct effect on corneal hysteresis and the biomechanical properties of the human cornea, according to Thomas John and colleagues from Loyola University, Chicago, USA. 

Endophthalmitis: sterile unit cefuroxime dose neededIf a sterile unit dose of cefuroxime were available it would become the world standard for endophthalmitis prophylaxis following the startling proof of its efficacy in the ESCRS endophthalmitis study last year. That was the conclusion of a debate for and against intracameral antibiotics at the JCRS Symposium, Controversies in Cataract & Refractive Surgery. 

Pentacam an excellent device with limitationsThe Pentacam (Oculus) is an excellent device, but it has limitations, the audience heard during a debate of the system's pros and cons in corneal diagnosis at the JCRS Symposium, Controversies in Cataract & Refractive Surgery. 

Refractive surgery will disappear to be replaced by RLEDr Howard I. Fine told delegates that he was the best ophthalmic surgeon because none of his patients used glasses. He then showed the audience a video of 'patients', all wearing spectacles, drinking directly from bottles of wine. It was a light finish in keeping with the session's theme, "I am the best because…". 

Microcoaxial torsional phaco method of choiceThe vast majority of ophthalmologists are going to become convinced that 2.2 mm microcoaxial surgery with Ozil (Alcon) phaco must be the method of choice for both surgeons and patients said Dr Robert Osher. 

SLT the number one choice for first-line treatmentSelective laser trabeculoplasty (SLT) is an effective method of long-term treatment for glaucoma, according to Madhu Nagar of the Clayton Eye Centre, UK. 

Glaucoma management: SLT on trialThe use of selective laser trabeculoplasty (SLT) in the management of glaucoma is a safe and effective treatment method, according to Shlomo Melamed from the Sam Rothbery Glaucoma Centre in Tel Aviv, Israel, speaking at the Ellex symposium. 

Surgeon recommends firms manufacture IOLs in 0.25 D stepsIt would be helpful if IOL manufacturers made lenses available in 0.25 D steps and provided more detailed information regarding the optical design since refractive outcomes can now be predicted more accurately, according to Thomas Olsen from the University Eye Clinic, Aarhus Hospital, Denmark. 

CustomVue offers good results in mixed astigmatismExcellent visual outcomes can be achieved in subjects with mixed astigmatism when using the VISX wavefront platform's CustomVue iris registration system (AMO), according to Baha Toygar and co-workers from the Dunya Eye Hospital, Istanbul, Turkey. 

A few simple changes can reduce endophthalmitis dramaticallyChanges to perioperative management of cataract patients, including the use of disposable bimanual irrigation/aspiration handpieces, intracameral cefuroxime and povidone iodine wash can be effective in reducing the instances of endophthalmitis, according to Richard Packer from the King Edward VII Hospital, Windsor, UK. 

ReSTORing good visionThe diffractive AcrySof ReSTOR (Alcon) intraocular lens (IOL) can provide stable, high levels of spectacle independence for both near and distance vision, according to Rudy Nuijts and colleagues from the Academic Hospital Maastricht, The Netherlands. 

Corneal ring segments proving their worthFerrara corneal rings are a useful tool in the treatment of keratoconus but long-term stability still needs to be established, according to Akef El Maghraby and colleagues from the Magrabi Eye and Ear Center, Jeddah, Saudi Arabia. 

Three lenses go head-to-headThe implantation of multifocal and accommodative intraocular lenses (IOLs) can offer adequate near and far vision in addition to high levels of patient satisfaction, according to Georgio Marchini and colleagues from the University of Verona, Italy. 

Combining ring segments and cross-linking yields good resultsImplantation of intracorneal ring segments (ICR) can be combined with a UV cross-linking procedure, according to Omid Kermani and colleagues from a private eye clinic in Schildergasse, Germany. 

90 micron flaps get the thumbs upUsing a femotsecond laser (IntraLase) to create flaps of 90 microns does not increase the postoperative risk of striae formation or induction of optical aberrations, according to Omid Kermani and colleagues from Augenklinik am Neumarkt, Cologne, Germany. 

Contrast performance best with zero spherical aberrationsBy using adaptive optics and physiological eye models, Pablo Artal and colleagues from Universidad de Murcia, Spain have determined that contrast performance peaks when spherical aberration is completely corrected. 

Bacteria building resistance to moxifloxacinAlthough moxifloxacin has excellent antibacterial coverage, there is an emergence of a resistance to it in bacteria isolated from corneal ulcers, according to Gita Sathpathy and co-workers at the All India Institute of Medical Sciences, New Dehli, India. 

A new concept: treating corneal amblyopia with corneal wavefront guided LASIKCases of amblyopia should undergo corneal wavefront analysis and would benefit from corneal wavefront-linked LASIK, according to Cyres and Keiki Mehta from the Mehta International Eye Institute and Supervision Laser Center, Mumbai, India. 

Akreos MICS lens gets the thumbs upCataract surgery with the Akreos MI60 microincision lens (Bausch & Lomb) is a safe and effective procedure, according to Jorge Alió and co-workers from VISSUM Instituto Oftalmologica de Alicante, Spain and study groups in France, Germany, Italy and Sweden. 

Cell loss no greater with femtosecond lasersPenetrating keratoplasty (PK) with a femtosecond laser offers good surgical results and endothelial cell loss numbers similar to those found for PK using standard trephines, according to Mike Holzer and co-workers at the International Vision Correction Research Centre, Heidelberg University, Germany. 

Acrylic lenses produce virtually no PCOThe new acrylic *Acri.Lyc 356 (*Acri.Tec) diffractive intraocular lens (IOL) produces practically no posterior capsule opacification (PCO) compared with its silicone counterpart, according to Filippo Simona from the LaserVis Refractive Centre, Locarno, Switzerland. 

LADAR 6000: good but time consumingAlthough the LADAR 6000 (Alcon) is accurate and safe, the need for pharmacological mydriasis and the use of a nomogram result in a more time consuming surgical procedure, according to Joaquim Murta and colleagues from Coimbra University, Portugal. 

LASIK & PRK: still looks good ten years onLASIK for myopia over -10 D is a safe procedure; myopic regression slows down with time and there is a high rate of best spectacle corrected visual acuity (BSCVA) increase in the long-term, according to Jorge Alió, MD and colleagues from the VISSUM Instituto Oftalmológico de Alicante and the Miguel Hernandez University Medical School, Spain. 

Zooming in on the implantable telescopeA long-term Phase II/III study (IMT002) of an implantable telescope prosthesis for end-stage macular degeneration has demonstrated that it can improve quality of life and sustain visual acuity (VA) improvements, according to Mark Packer, one of the trial investigators from the USA. 

Staged IOL implantation = happy patientsBy employing staged implantation of intraocular lenses (IOLs), surgeons can produce the best possible visual outcomes for each individual patient, according to Richard Lindstrom from Minnesota, USA. 

IOL type determines complications in phakic surgeryThe type of phakic IOL chosen strongly governs the type of complication that is likely to occur in the long-term. Posterior, angle-supported anterior and iris supported anterior phakic IOLs all have different issues that face the surgeon. 

Sulcoflex: a new IOL concept for the pseudophakic eyeThe new sulcoflex intraocular lens (IOL), which has been designed for sulcus-implantation in the pseudophakic eye ("piggy back"), is safe and well-tolerated, according to Michael Amon, MD from the University of Vienna Medical School, Austria. 

Preop and postop imaging vital for phakic IOLsPreop and postop imaging and endothelial cell counts are vital to check the position and performance of a phakic IOLs, Dr David Hardten told colleagues. 

Improving astigmatism correction with a rotation-stable, bitoric, aspherical IOL and coaxial MICSImplantation of the bitoric, aspherical intraocular lens (IOL), *Acri.Comfort 646 TLC (*Acri.Tec), is rotation-stable and associated with excellent levels of astigmatism correction in cataract patients, according to Detlev Breyer, a high volume surgeon of ZeitzBreyer-Augenheilkunde an den Schadow Arkaden in Düsseldorf, Germany. 

Fluoroquinolones: do not taper doseTapering the dose of a topical fluoroquinolone at the end of a course of treatment is a great way to build up bacterial resistance. As such, doctors must not taper the dosage at the end of treatment, according to Dr Richard L. Abbott. 

PRL offers good results for high myopiaImplantation of phakic refractive lenses (PRL) appears to be a predictable and well-tolerated procedure for correcting high myopia, according to Esther Arranz-Marquez and co-workers from Vissum Corporación Oftalmológica de Madrid, Spain. 

Visian ICL offers good long-term BSCVAOver a five-year follow-up period the Visian implantable collamer lens (ICL) (STAAR Surgical) maintains a good level of best spectacle corrected visual acuity (BSCVA), according to results from the US multicentre FDA study, as reported by John Vukich of Madison, Wisconsin, USA. 

Signature phaco machine offers good stabilityAnterior chamber fluctuations during phacoemulsification can cause an increase in retinal thickness and alterations of the blood aqueous barrier. In order to avoid these complications, it is better to use a machine that offers good anterior chamber stability, according to Alessandro Franchini and colleagues from the University of Florence, Italy. 

AcrySof toric IOL offers spectacle independenceThe AcrySof toric intraocular lens (IOL) (Alcon) offers greater spectacle independence than the monofocal AcrySof SA60AT single-piece IOL (Alcon), according to Paul Ernest from Jackson, USA. 

Aspheric ablation good for hyperopic presbyopesAspheric ablation is a good surgical option for enhancing near vision in hyperopic presbyopes, according to Marc Lafontaine and colleagues from the Canadian multicentre LASIK trial of aspheric treatments for the correction of hyperopic presbyopia. 

Subtenons anaesthesia more comfortable for photophobicsPatients who report photophobia prior to phacoemulsification may be more comfortable under subtenon anaesthesia, according to Alexander Ioannidis and colleagues from the Mid-Essex Hospitals NHS Trust, London, UK. 

Blue blocking IOLs are not the best optionUltraviolet (UV) and violet blocking intraocular lenses (IOLs) can provide protection from radiation and offer good quality of vision, however, blocking blue light can actually cause a loss in quality of vision, according to Alessandro Franchini and Eleonora Vaccari from the University of Florence, Italy. 

Microcoaxial phaco better than standard phacoMicrocoaxial phacoemulsification induces significantly less keratometric changes and provides better visual acuity than standard phacoemulsification, according to Seyed Javad Hashemian and colleagues from the Fajr Hospital & Negah Eye Hospital, Tehran, Iran. 

Cataract surgery-induced dry eye may not be a direct consequence of surgeryDry eye following cataract surgery may not be a direct result of the surgery but rather the surgery triggers symptoms in eyes with pre-existing sub-optimal tear properties, according to Waheeda Illahi and colleagues from BMEC, City Hospital, Birmingham, UK. 

Oval instruments ease bimanual cataract surgeryUsing oval choppers and needles during bimanual cataract surgery spares energy and maintains anterior chamber stability, according to Fernando Araujo-Gomes from the Clinica de Santo Antonio, Amadora, Portugal. 

CK improves near vision in post-LASIK and plano presbyopic eyesNearVision conductive keratoplasty (CK) (Refractec) offers a minimally invasive method of enhancing near vision in plano presbyopes and in post-LASIK eyes, according to the results of an FDA presbyopia study and a CK post-LASIK study, as presented by Marguerite McDonald of Tulane University School of Medicine, New Orleans, USA. 

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