MedWorm: Cataract Removal

Complication Rate Higher With Combined Cataract/glaucoma Surgery

Medscape Ophthalmology Headlines — Mon, 15 Mar 2010 18:56:36 +0100

In patients with cataracts and glaucoma, phacotrabeculectomy to treat both conditions at once produces more surgical complications than phacoemulsification for just the cataracts, researchers say in the March Archives of Ophthalmology. Reuters Health Information (Source: Medscape Ophthalmology Headlines)

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Abbott Receives U.S. FDA Approval For New Cataract Multifocal Intraocular Lens

Health News from Medical News Today — Sat, 13 Mar 2010 09:00:00 +0100

Abbott (NYSE: ABT) announced it has received U.S. Food and Drug Administration (FDA) approval for the TECNIS® Multifocal 1-Piece intraocular lens (IOL) for cataract patients with and without presbyopia. Intraocular lenses are implanted in a patient's eye after the removal of the natural lens that has become clouded by a cataract... (Source: Health News from Medical News Today)

Abbott Receives U.S. FDA Approval For New Cataract Multifocal Intraocular Lens

Medical Devices News From Medical News Today — Sat, 13 Mar 2010 09:00:00 +0100

Abbott Receives U.S. FDA Approval For New Cataract Multifocal Intraocular Lens

Health News from Medical News Today — Thu, 11 Mar 2010 10:00:00 +0100

Abbott (NYSE: ABT) announced today it has received U.S. Food and Drug Administration (FDA) approval for the TECNIS® Multifocal 1-Piece intraocular lens (IOL) for cataract patients with and without presbyopia. Intraocular lenses are implanted in a patient's eye after the removal of the natural lens that has become clouded by a cataract... (Source: Health News from Medical News Today)

Abbott Receives U.S. FDA Approval For New Cataract Multifocal Intraocular Lens

Medical Devices News From Medical News Today — Thu, 11 Mar 2010 10:00:00 +0100

Hormone replacement therapy now linked to cataracts

NaturalNews.com — Thu, 11 Mar 2010 07:00:00 +0100

(NaturalNews) For decades, hormone replacement therapy (HRT) was pushed by the medical establishment as a kind of youth elixir that offered all sorts of remarkable benefits. Take the hormones Big Pharma concocts from pregnant horses' urine and chemicals and middle-aged and older women would supposedly have better sex lives, fewer wrinkles, protection from heart attacks and no more hot flashes. Only, it was all a huge myth. In fact, as the years passed and rates of breast cancer soared in women who took HRT, the truth began to be revealed. HRT didn't protect health at all. In fact, it caused breast and ovarian cancer (http://www.naturalnews.com/027617_HRT_drugs_ovarian_cancer.html), upped heart attack risk and was even linked to brain shrinkage (http://www.naturalnews.com/025371_women_brain...

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Hormone Therapy May Up Risk of Needing Cataract Removal

Modern Medicine — Thu, 11 Mar 2010 00:00:00 +0100

Postmenopausal women taking hormone replacement therapy are more likely to undergo cataract removal than their counterparts who never used hormone replacement therapy, and the relative risk is higher among women on hormone replacement therapy who also drink more than one alcoholic drink a day, according to a study in the March issue of Ophthalmology. (Source: Modern Medicine)

Cataract Surgery Among Veterans 65 Years of Age and Older: Analysis of National Veterans Health Administration Databases

American Journal of Medical Quality — Wed, 10 Mar 2010 23:43:26 +0100

The authors examine the rates of cataract surgery as a crude measure of appropriateness of care among veterans 65 years of age and older who use Veterans Health Administration (VHA). Data were obtained from the national VHA data sets for fiscal years 2000 through 2007, using International Classification of Diseases codes and the American Medical Association’s Current Procedural Terminology codes. Cataract surgery was expressed as procedures per 10 000 veteran beneficiaries per fiscal year. The annual incidence of cataract surgery increased marginally over the study period with an average annual incidence of 105.8 surgeries per 10 000 beneficiaries. Institutional rates of VHA surgery differ substantially from those of Medicare beneficiaries, which are approximately 5.5-fold greater. A...

Congenital ocular malformations (lens subluxation, pupillary displacement, cataract, myopia) and classic galactosaemia associated with Q188R and /or G1391A mutations

Acta Ophthalmologica — Wed, 10 Mar 2010 00:00:00 +0100

Conclusions: Patients with worsening cataracts occurring at a pre-senile age should be examined for galactosaemia. We describe for the first time the molecular genetic findings in congenital ectopia lentis et pupillae. Early treatment in conjunction with a galactose-free diet is mandatory in patients with galactosaemia. Members of a family with heterozygosity for galactosaemia should be advised to attend a human genetic consultation. (Source: Acta Ophthalmologica)

Anti-depressants and cataracts

Medicineworld.org: New Article Alert — Tue, 09 Mar 2010 14:04:37 +0100

Some anti-depressant drugs are linked to an increased chance of developing cataracts, as per a new statistical study by scientists at the University of British Columbia, Vancouver Coastal Health Research Institute and McGill University. The study, based on a database of more than 200,000 Quebec residents aged 65 and older, showed statistical relationships between a diagnosis of cataracts or cataract surgery and the class of drugs called selective serotonin reuptake inhibitors (SSRIs), as well as between cataracts and specific drugs within that class........ (Source: Medicineworld.org: New Article Alert)

Risk Of Developing Cataracts Increased By Anti-Depressants

Health News from Medical News Today — Tue, 09 Mar 2010 13:00:00 +0100

Some anti-depressant drugs are associated with an increased chance of developing cataracts, according to a new statistical study by researchers at the University of British Columbia, Vancouver Coastal Health Research Institute and McGill University. The study, based on a database of more than 200,000 Quebec residents aged 65 and older, showed statistical relationships between a diagnosis of cataracts or cataract surgery and the class of drugs called selective serotonin reuptake inhibitors (SSRIs), as well as between cataracts and specific drugs within that class... (Source: Health News from Medical News Today)

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Phacoemulsification vs Phacotrabeculectomy in Chronic Angle-closure Glaucoma With Cataract Complications [Clinical Sciences]

Archives of Opthalmology — Mon, 08 Mar 2010 20:50:47 +0100

Conclusions Combined phacotrabeculectomy resulted in significantly more surgical complications than phacoemulsification alone in CACG eyes with coexisting cataract. There was no difference in visual acuity or disease progression between the 2 treatment groups. (Source: Archives of Opthalmology)

Antidepressants May Increase Risk of Cataracts

About.com Depression — Mon, 08 Mar 2010 11:22:44 +0100

This study is the first to identify a statistical link between these antidepressants and cataracts in humans, although previous animal studies had shown that SSRIs could increase cataract risk. The authors note that this study does not prove causation, only that there is a statistical link between the two. They further note that the study was unable to account for smoking - which is a known risk factor for cataracts - and additional studies are needed to confirm their findings. The authors do not believe that this study should be cause for concern. "When you look at the trade-off of these drugs," said lead author Dr. Mahyar Etminan, "the benefits of treating depression - which can be life-threatening - still outweigh the risk of developing cataracts, which are treatable and relatively be...

Does HRT use raise women's cataract risk?

ScienceDaily Headlines — Tue, 02 Mar 2010 13:00:00 +0100

An eight-year prospective study of more than 30,000 postmenopausal Swedish women found that those who were using or had used HRT had significantly higher rates of cataract removal, compared with women who had never used HRT. Alcohol consumption seemed to increase HRT's harmful effect. (Source: ScienceDaily Headlines)

Women's Hormone Replacement Therapy Linked To Cataracts; Smoking May Raise Uveitis Risk

Health News from Medical News Today — Tue, 02 Mar 2010 09:00:00 +0100

Intriguing findings on hormone replacement therapy (HRT) and cataract risk, and on smoking and uveitis risk are reported in this month's Ophthalmology,the journal of the American Academy of Ophthalmology. Does HRT Use Raise Women's Cataract Risk? An eight-year prospective study of more than 30,000 postmenopausal Swedish women found that those who were using or had used HRT had significantly higher rates of cataract removal compared with women who had never used HRT. Alcohol consumption seemed to increase HRT's harmful effect. The HRT study was led by Birgitta E... (Source: Health News from Medical News Today)

Long-term visual acuity and its predictors after cataract surgery in patients with uveitis.

European Journal of Ophthalmology — Tue, 02 Mar 2010 00:00:00 +0100

Conclusions. The outcomes of phacoemulsification and IOL implantation in patients with uveitis were satisfactory. Patients with observed preoperative macular lesions are at risk for poor visual outcome. PMID: 20213617 [PubMed - as supplied by publisher] (Source: European Journal of Ophthalmology)

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Understanding why patients with cataract refuse free surgery: the influence of rumours in Kenya

Tropical Medicine and International Health — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion In Africa, a rumour of blinding eye surgery is not uncommonly being used by patients to justify their refusal to have cataract surgery. Underlying reasons appear to be related to shame, fear of surgery or missing social support. Improved awareness of the general population regarding eye conditions and their management, involvement of the family and local community in decision making, good surgical outcomes and appropriate counselling are possible methods to enhance acceptance. (Source: Tropical Medicine and International Health)

Negative dysphotopsia following cataract surgery

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

There are two kinds of light—the glow that illuminates and the glare that obscures.James Thurber One of the most vexing symptoms that can affect patients following modern cataract surgery is dysphotopsia. This photic phenomenon, which occurs in pseudophakic patients, has many different forms. So-called positive dysphotopsia is usually noted as phenomena such as light rings, arcs, streaks, flashes, and halos that may interfere with vision. These images are noted near the central axis of vision and can be induced by peripheral light sources. Positive dysphotopsia is usually related to bright artifacts of light on the retina. Tester et al. used the term dysphotopsia to describe the visual phenomena encountered by phakic and pseudophakic patients, including flashes of light, glare, and lig...

Scleral fixation of intraocular lenses combined with penetrating keratoplasty

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

I describe a technique for transscleral fixation of a posterior chamber intraocular lens (PC IOL) combined with penetrating keratoplasty. Partial-thickness trephination of the cornea is followed by full-thickness penetration of the anterior chamber at 12 o'clock and 6 o'clock through 5.5 and 2.0mm incisions, respectively. Scleral fixation of a PC IOL is performed through the incisions under a closed chamber followed by replacement of the diseased graft with a donor button. The results in 5 eyes of 5 patients with aphakic bullous keratopathy and lack of capsule support are reported.Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Hydroimplantation: Foldable intraocular lens implantation without an ophthalmic viscosurgical device

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

I describe a technique for implantation of a 1-piece acrylic foldable intraocular lens (IOL) using an irrigation cannula of the phaco machine without using an ophthalmic viscosurgical device (OVD). The irrigating cannula introduced through a side port provides excellent stability and positioning to the eye; if required, the cannula tip is used to guide the leading haptic of the IOL into the capsular bag. The fluid coming from the side port via a bimanual irrigation cannula maintains adequate formation of the capsular bag and anterior chamber while the foldable IOL is inserted. The hydroimplantation technique has the advantage of increased efficiency, reduced surgical time and cost, no need for OVD removal from behind the IOL or for additional instrumentation, no OVD-induced intraocular pr...

Functional assessment of accommodating intraocular lenses versus monofocal intraocular lenses in cataract surgery: Metaanalysis

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: There was no clear evidence of near acuity improvement despite statistically significant pilocarpine-induced anterior lens displacement. Further randomized controlled studies with standardized methods evaluating adverse effects (eg, PCO) are needed to clarify the tradeoffs.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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Color discrimination by patients with different types of light-filtering intraocular lenses

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Filtering blue lights under mesopic conditions seemed to modify color discrimination in the green-to-blue bands postoperatively. The modification did not disturb overall color discrimination or cause subjective discomfort.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Optical aberrations in professional baseball players

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Professional baseball players have small higher-order optical aberrations when tested with naturally dilated pupils. No clinically significant differences were found between the 2 aberrometers. Statistically significant differences in trefoil were found between the players and the control population; however, the difference was clinically insignificant. It seems as though the visual system of professional baseball players is limited by lower-order aberrations and that the smaller HOAs do not enhance visual function over that in a control population.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Oral acetaminophen (paracetamol) for additional analgesia in phacoemulsification cataract surgery performed using topical anesthesia: Randomized double-masked placebo-controlled trial

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Purpose: To evaluate the clinical analgesic efficacy of 1.0 g oral acetaminophen (paracetamol) given in addition to topical anesthesia before phacoemulsification cataract surgery.Setting: Inpatient and outpatient ophthalmology clinics, Bydgoszcz, Poland.Methods: Consecutive patients with age-related cataract having phacoemulsification under topical anesthesia (tetracaine 0.5%) were enrolled in a prospective double-blind randomized placebo-controlled study. Patients were randomly assigned to preoperative oral administration of a placebo medication or to oral administration of 1.0 g acetaminophen. The main outcome measure was intensity of pain during and after surgery. Pain intensity was measured using a 10 cm baseline visual analog scale and a discrete 5-category verbal rating scale.Results...

Phacoemulsification versus phacoemulsification with micro-bypass stent implantation in primary open-angle glaucoma: Randomized double-masked clinical trial

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Phacoemulsification with stent implantation was more effective in controlling IOP than phacoemulsification alone; the safety profiles were similar.Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Surgically induced astigmatism after phacoemulsification with and without correction for posture-related ocular cyclotorsion: Randomized controlled study

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Attempts to correct for posture-related ocular cyclotorsion did not influence SIA or its variance in a single-surgeon series. These results should be interpreted with full appreciation of the limitations of currently available techniques to correct for posture-related ocular cyclotorsion in the clinical setting.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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Intraocular lens exchange in patients with negative dysphotopsia symptoms

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: The iris–optic distance was not statistically significantly different between eyes with severe negative dysphotopsia symptoms and nonsymptomatic eyes. However, when IOL exchange reduced the iris–IOL distance, the severe negative dysphotopsia symptoms resolved.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Repeatability of corneal power and wavefront aberration measurements with a dual-Scheimpflug Placido corneal topographer

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Purpose: To evaluate the repeatability of the Galilei dual-Scheimpflug analyzer in measuring corneal curvature, wavefront aberrations, pachymetry, and anterior chamber depth (ACD).Setting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.Methods: Three consecutive measurements were performed in 1 eye of each subject. The following were evaluated: (1) mean total corneal power at the central, paracentral, and peripheral zones (0.0 to 4.0 mm, 4.0 to 7.0 mm, and 7.0 to 8.0 mm, respectively) and posterior corneal power (Kavg); (2) corneal higher-order wavefront aberrations (6.0 mm pupil); (3) mean pachymetry at the central, paracentral, and peripheral zones; and (4) ACD. Repeatability was assessed by calculating the within-subject standard deviation (SD), coefficient of var...

Manual limbal markings versus iris-registration software for correction of myopic astigmatism by laser in situ keratomileusis

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Manual limbal markings and iris-registration software were equally effective and safe in LASIK for myopic astigmatism, showing that checking cyclotorsion by manual limbal markings is a safe alternative when automated systems are not available.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Visual acuity and higher-order aberrations with wavefront-guided and wavefront-optimized laser in situ keratomileusis

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Wavefront-guided LASIK and wavefront-optimized LASIK produced equivalent visual outcomes and no differences in HOAs. Wavefront-guided treatment could not be performed in many eyes because of difficulties during wavefront measurement.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. (Source: Journal of Cataract and Refractive Surgery)

Efficacy, safety, and flap dimensions of a new femtosecond laser for laser in situ keratomileusis

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Overall, the flap dimensions and refractive results were predictable and the complication rate was acceptable after LASIK using the new femtosecond laser for flap creation.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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First clinical results of epithelial laser in situ keratomileusis with a 1000 Hz excimer laser

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: In this pilot series, the use of the 1000 Hz excimer laser did not lead to the clinical side effects that are potentially associated with the use of a high repetition rate. The safety, stability, and efficacy of the laser were high although no adjustments to the nomogram were made.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. (Source: Journal of Cataract and Refractive Surgery)

Limbal relaxing incisions at the time of apodized diffractive multifocal intraocular lens implantation to reduce astigmatism with or without subsequent laser in situ keratomileusis

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Purpose: To evaluate the visual and refractive outcomes of limbal relaxing incisions (LRIs) to reduce astigmatism at the time of apodized diffractive multifocal intraocular lens (IOL) implantation.Setting: University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.Methods: This retrospective review comprised consecutive patients who had LRIs at the time of lens extraction and AcrySof ReSTOR IOL implantation. A subgroup of patients had subsequent laser in situ keratomileusis (LASIK) for residual refractive error correction.Results: The study evaluated 73 eyes (59 patients); 21 eyes (28.7%) of 59 patients had further LASIK (LRI+LASIK). The mean follow-up was 13.2 months ± 6.4 (SD). The mean keratometric astigmatism decreased from 1.49 ± 0.71 diopters (D) preoperatively t...

Straylight measurements in laser in situ keratomileusis and laser-assisted subepithelial keratectomy for myopia

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Purpose: To compare straylight values before and 3 months after laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) and to analyze the causes of any change.Setting: Private refractive surgery clinic, Driebergen, The Netherlands.Methods: Straylight was measured before and after LASIK or LASEK with a C-Quant straylight meter; values were recorded as the straylight parameter log(s). Main outcome measures were the difference between postoperative and preoperative straylight values and factors causing a difference between the values.Results: The study evaluated 102 eyes having LASIK and 137 eyes having LASEK. On average, there was significant improvement in straylight values postoperatively in both groups. The mean decrease was −0.016 log(s) in the LASIK ...

Keratorefractive effect of microwave keratoplasty on human corneas

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Microwave keratoplasty reduced corneal curvature and has therapeutic potential as a noninvasive alternative to excimer laser surgical correction of myopia and as a treatment for corneal ectasia.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. (Source: Journal of Cataract and Refractive Surgery)

Comparison of real-time intraocular pressure during laser in situ keratomileusis and epithelial laser in situ keratomileusis in porcine eyes

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Purpose: To compare real-time intraocular pressure (IOP) between laser in situ keratomileusis (LASIK) and epithelial LASIK (epi-LASIK) in porcine eyes during flap creation using a microkeratome or an epikeratome, respectively.Setting: Vissum Madrid, Madrid, Spain.Methods: In this prospective study, a Moria microkeratome was used in 1 eye (LASIK group) and an Epi-K epikeratome in the other eye (epi-LASIK group) to create a lamellar corneal flap and an epithelial flap, respectively, in freshly enucleated porcine eyes. The IOP changes during the procedures were recorded by direct cannulation using a reusable blood pressure transducer connected to the anterior chamber.Results: Each group comprised 17 eyes. In the LASIK group, the mean IOP was 113.65 mm Hg ± 10.78 (SD) during suctioning and 11...

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Acrylic intraocular lens damage after folding using a forceps insertion technique

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: The anterior optic surface of the acrylic IOL was vulnerable to forceps-induced surface depressions. Surface abnormalities were prevented by coating the anterior optic surface with OVD before grasping it with a metal insertion forceps.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Ocular penetration of topically applied linezolid in a rabbit model

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Linezolid levels in the aqueous humor, conjunctiva, and cornea exceeded the minimum inhibitory concentration of most gram-positive organisms that cause bacterial keratitis and endophthalmitis. Linezolid could be a valuable alternative in cases of increased resistance to vancomycin.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Effect of varying microkeratome parameters on laser in situ keratomileusis interface surfaces

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Purpose: To evaluate the effect of altering microkeratome parameters (oscillation rates and head-advance speeds) and repeated blade use on human and porcine laser in situ keratomileusis interface surface quality and to evaluate correlations between human and porcine interface surface quality.Setting: Emory Vision, Atlanta, Georgia, USA.Methods: Corneal flaps were created in porcine eyes and human cadaver eyes with an Amadeus I microkeratome using varying head-advance speeds and oscillation rates. Microkeratome blades were used once in 18 porcine eyes, twice in 18 human eyes (simulating clinical use), and 5 times in 15 porcine eyes. The interface surface was imaged with electron microscopy, with overall bed quality and surface smoothness graded from 1 to 5 (smoothest to roughest) by 5 maske...

Pseudophakic eye with obliquely crossed piggyback toric intraocular lenses

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

A 72-year-old man presented with high astigmatism (2.25 −5.0 × 45) induced by long-term rotation of a toric intraocular lens (IOL). Corneal astigmatism was 3.78 diopters (D). The corrected distance visual acuity (CDVA) was 20/32. Because of the risk of repositioning, a secondary toric IOL of −3.0/6.0 D especially designed for sulcus implantation was piggybacked through 3.5 mm sutureless clear-corneal incision with a cylindrical axis obliquely crossed with that of the primary IOL. Eight months postoperatively, the corneal astigmatism was 5.04 D. The CDVA was 20/25 with a refraction of 1.0 −2.5 × 70. No interlenticular opacification or significant rotation or decentration of the secondary toric IOL was observed. The refractive properties of this pseudophakic eye were analyzed using a...

Immunohistochemical observation of anterior subcapsular cataract in eye with spontaneously regressed retinoblastoma

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

We report the histological findings of secondary cataract in an eye with a spontaneously regressed retinoblastoma to obtain keys to clarify the mechanism of this phenomenon. During phacoemulsification, opacified anterior capsule was obtained, fixed in formalin, and embedded in paraffin. Paraffin sections of the specimen were histologically observed. Hematoxylin–eosin staining showed extracellular matrix accumulation in the extracted fibrous anterior subcapsular opacification. Immunohistochemistry revealed the presence of fibrous collagen types and cellular fibronectin. Presumed lens cells amid matrix were positively labeled for vimentin, α-smooth muscle actin, and phospho-Smad2. Histology of the fibrous anterior subcapsular opacification tissue showed the possibility of epithelial-mesen...

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Bilateral Descemet membrane detachment after canaloplasty

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

We report a case of bilateral Descemet membrane detachment (DMD) after canaloplasty in a 70-year-old Portuguese man with primary open-angle glaucoma. The patient developed bilateral DMD immediately following consecutive (1 week apart) canaloplasty surgery in both eyes. Slitlamp biomicroscopy, gonioscopy, and Fourier-domain optical coherence tomography (FD-OCT) findings are described. On postoperative day 1, in both cases, slitlamp biomicroscopy revealed an unscrolled inferonasal DMD and a clear cornea with deep and quiet anterior chambers. Gonioscopy showed an intact, lightly pigmented, and distended trabecular meshwork with no evidence of suture extrusion. High-resolution FD-OCT revealed a widely dilated canal of Schlemm, trabecular distention, and a retrocorneal hyperreflective membrane ...

Long-term pathological follow-up of obsolete design: Pannu universal intraocular lens

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

We studied an enucleated postmortem eye from an 82-year-old white donor who had been implanted with a Pannu “universal” intraocular lens (IOL) in the anterior chamber approximately 20 years earlier. This IOL has design features characteristic of a 1-piece, C-loop posterior chamber IOL. Magnetic resonance imaging showed a relatively well-centered IOL in the anterior chamber with haptics impinging on the iris. Gross and light microscopic analyses of the eye and the IOL showed peripheral anterior synechiae enclaving one haptic, areas of angle widening, significant attenuation of the corneal endothelium, multiple areas of iris trauma secondary to optic and haptic iris abrasion, large areas of pigment dispersion in the angle, diffuse pigment accumulation within the anterior chamber, and att...

Pseudomonas keratitis after collagen crosslinking for keratoconus: Case report and review of literature

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

A 19-year-old woman presented with a 3-day history of pain, redness, and diminution of vision occurring one day after collagen crosslinking (CXL) with riboflavin and ultraviolet-A had been performed for keratoconus in the right eye. On presentation, severe keratitis with a 7.0mm×6.0mm central infiltrate was present. Culture results from the patient's contact lens and corneal scrapings were positive for Pseudomonas aeruginosa. Keratitis can occur following CXL because of the presence of an epithelial defect, use of a soft bandage contact lens, and topical corticosteroids in the immediate postoperative period, and patients should be counseled about it.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and...

Efficacy of topical anesthesia for foldable phakic intraocular lens implantation for the correction of myopia

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Topical anesthesia is not widely used for foldable Artiflex phakic intraocular lens (pIOL) (Ophtec BV) implantation. Retrobulbar, peribulbar, and even general anesthesia are the more common techniques. As a less invasive technique, topical anesthesia reduces the risk for systemic complications and eliminates the complications from injection anesthesia such as globe perforation, retrobulbar hemorrhage, retinal vascular occlusion, ptosis, and optic nerve damage. The advantages of topical anesthesia are faster visual recovery, higher patient satisfaction, easy application, minimal discomfort on administration, rapid onset of anesthesia, and lower costs. To my knowledge, this is the first report of the efficacy of topical anesthesia for implantation of an Artiflex pIOL for the correction of my...

Partial retraction of Malyugin pupil expansion device to improve safety during ring removal

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

The iris billowing, iris prolapse, and intraoperative miosis associated with intraoperative floppy-iris syndrome (IFIS) can limit the anterior segment surgeon's ability to perform efficient and safe phacoemulsification. Identification of the association between systemic α-antagonists and IFIS has allowed appropriate planning and anticipation of surgical events. Several authors have described techniques for approaching these cases. The Malyugin pupil expansion device, which was recently introduced, has become the preferred device for IFIS cases in our training program because of its ease of use and the predictable pupillary aperture. Despite our enthusiasm, we have occasionally observed intraoperative behaviors of the Malyugin ring that can limit safe usage. For example, complete retrieval...

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Epi-Shugarcaine with plain balanced salt solution for prophylaxis of intraoperative floppy-iris syndrome

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

In 2005, Chang and Campbell published their finding of the association between intraoperative floppy-iris syndrome (IFIS) and tamsulosin (Flomax), a systemic α1-adrenergic antagonist typically prescribed for symptoms of benign prostatic hypertrophy. Intraoperative floppy-iris syndrome is characterized by loss of the normal muscle tone of the iris, resulting in persistent iris prolapse to the wound and intraoperative miosis. Since the first report, several preoperative and intraoperative strategies to combat this vexing problem have been designed. These strategies range from the use of preoperative cycloplegia with atropine, iris retractors, the Malyugin ring, altered fluidic parameters for phacoemulsification, and more retentive ophthalmic viscosurgical devices (OVDs) such as sodium hyalu...

Refractive Surgical Problem: March consultation #1

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

A 34-year-old woman had laser in situ keratomileusis (LASIK) in both eyes in August 2000 at another clinic. Preoperatively, the corrected distance visual acuity (CDVA) was 20/25 with −8.25 −0.50 × 175 in the right eye and 20/20 with −7.50 −0.75 × 175 in the left eye. Although no topographic information is available, Javal keratometry was 45.0/46.0@85 in the right eye and 45.0/46.0@90 in the left eye and central ultrasonic pachymetry was 522 μm and 529 μm, respectively. (Source: Journal of Cataract and Refractive Surgery)

March consultation #2

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Late corneal ectasia is a rare complication of LASIK that could not have been anticipated in this patient at the time of surgery. The patient's vision has been good for 8 years, decreasing thereafter in the left eye only. Although the attempt to correct the ectasia with ICRS implantation cannot be commended, the high astigmatism likely developed because 2 segments were implanted rather than only an inferior segment, which is all that was required. After ring segment explantation, we must still solve the problem in the left eye, which will probably extend to the right eye in the near future. (Source: Journal of Cataract and Refractive Surgery)

March consultation #3

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

From the data given, there is no real need for additional testing because there seems to be a clear progression from 5 to 9 years postoperatively. That the surgeon implanted ICRS in the left eye confirms this. (Source: Journal of Cataract and Refractive Surgery)

Factors affecting stromal hydration of clear corneal incision architecture

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

We have some comments about the article by Calladine et al. that we would like to share with the authors. First, one factor that might cause the difference in architecture between hydrated clear corneal incisions (CCIs) and nonhydrated CCIs is the corneal stromal edema at the incision site induced by hydration. The authors might have to record the grade of edema at the CCIs before hydration under the surgical microscope. This measurement could serve as the baseline status of the CCI edema before hydration. The difference in the baseline status between the 2 study groups might contribute to the architectural differences detected by anterior segment optical coherence tomography. (Source: Journal of Cataract and Refractive Surgery)

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Letter to the Editor

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

I congratulate Calladine et al. on conducting a very useful and informative study. With an increasing number of cataract surgeons making smaller clear corneal incisions, it is important to know whether stromal hydration improves wound integrity and reduces the risk for wound leakage. (Source: Journal of Cataract and Refractive Surgery)

Reply: Factors affecting stromal hydration of clear corneal incision architecture

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

The comments of Hu et al. and Zaffar highlight some of the challenges faced when conducting similar clinical studies. While we recognize that a small amount of corneal edema at the CCI site commonly occurs as a direct result of cataract surgery, it is unlikely to occur in large amounts in routine cases. If a significant amount of edema occurs, it is easily visible at the end of surgery as a local area of white corneal opacification around the CCI; this was not seen in our study. In our study, stromal hydration was performed generously with balanced salt solution to produce a visibly significant amount of local corneal edema. While we accept this was a subjective intervention, the optical coherence tomography (OCT) images are objective and clearly demonstrate the boundary between hydrated ...

Benefits of stromal hydration

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

We appreciate Calladine et al.'s very relevant study highlighting the benefits of performing stromal hydration at the end of phacoemulsification surgery. The architecture and integrity of clear corneal incisions are crucial in preventing endophthalmitis. Ingress of contaminants from the ocular surface into the anterior chamber has been speculated as an important mechanism for postoperative contamination. This may be particularly relevant ain cases of early postoperative hypotony. (Source: Journal of Cataract and Refractive Surgery)

Variation of cross-chop technique

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

I read with interest the cross-chop technique described by Kim during which the chopper is used to make a horizontal chop in the heminucleus with the phaco probe bracing the fragment; the name comes from the “X” configuration caused by crossing the instruments. This technique is said to be a safe and consistent method of disassembling the lens without rotating the nucleus; it is particularly recommended for weak zonules. I agree this is an excellent technique and have been using it successfully to avoid rotating the nucleus when tackling complicated cataracts, such as the dense posterior polar cataract. (Source: Journal of Cataract and Refractive Surgery)

Reply: Variation of cross-chop technique

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

I have read Chee's article on posterior polar cataracts describing a similar rotationless chop technique. Similar to many innovative concepts in surgery, cross chop is a modification of preexisting techniques. Chee's success affirms my feeling that cross chop is reliable and safe; however, I would like to highlight a few distinctions. (Source: Journal of Cataract and Refractive Surgery)

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Intraocular lens calculation in extreme myopia

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Haigis suggests a solution to overcome the problem of a systematic hyperopic outcome of intraocular lens (IOL) calculations with third-generation formulas in very long eyes. He proposes to distinguish between positive and negative IOL powers by different formula constants. For his formula, he proposed a constant of a0 = 2.77 mm for positive power IOLs and of a0 = 1.73 mm for negative power IOLs, corresponding to the SRK/T A-constants of 121.2 and 114.4, respectively. In a subsequent paper with Haigis as a coauthor, these A-constants were modified to 126.63 for positive-power MA60MA IOLs (Alcon, Inc.) and 104.43 for negative-power MA60MA IOLs. (Source: Journal of Cataract and Refractive Surgery)

Reply: Intraocular lens calculation in extreme myopia

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Systematic hyperopic outcomes after IOL implantations in extreme myopia are frequently observed clinically. I traced the problem to the use of the same IOL constants for both plus and minus IOLs and proposed as a solution to distinguish between positive and negative IOL powers by separate sets of IOL constants. This concept was shown to work in model calculations in my article as well as with clinical data in the Petermeier et al. article, producing a mean arithmetic prediction error of 0 D (see also typical results for one patient in ). (Source: Journal of Cataract and Refractive Surgery)

Limitations of Fourier-domain OCT

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

At the time of writing this letter, the RTVue-100 (Optovue, Inc.) used by Wylęgala et al. is the only commercially available Fourier-domain optical coherence tomography (OCT) device that can scan the anterior segment without “personal” modifications. Similar to all commercially available Fourier-domain OCT devices, it uses shorter wavelength light than the Visante-OCT (Carl Zeiss Meditec) (840 nm versus 1310 nm). It scans at a faster rate (26 000 A-scans/s) than time-domain OCT devices (2048 A-scans/s for Visante-OCT). This improves image quality by achieving higher resolution and also reducing motion artifact. (Source: Journal of Cataract and Refractive Surgery)

Reply: Limitations of Fourier-domain OCT

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

We can definitely claim that anterior segment OCT is a noncontact, high-resolution imaging technique with many possible clinical applications: keratoplasty, keratorefractive surgery, Descemet membrane detachment, ocular injury; even corneal infectious diseases. As far as we know, there are 3 commercially available spectral domain anterior segment modalities that do not require personal modifications: RTVue-100 (Optovue Inc.), Cirrus HD-OCT model 4000 (Carl Zeiss Meditec), and SOCT Copernicus HR (Optopol Technology SA). (Source: Journal of Cataract and Refractive Surgery)

Erratum

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

In the December issue, in the article “Preoperative Topical Moxifloxacin 0.5% and Povidone–Iodine 5.0% Versus Povidone–Iodine 5.0% Alone to Reduce Bacterial Colonization in the Conjunctival Sac” (J Cataract Refract Surg 2009;35:2109-2114), the name of the first author is spelled incorrectly. The correct name of the first author is Orly Halachmi-Eyal, MD. (Source: Journal of Cataract and Refractive Surgery)

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Editorial Board

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

(Source: Journal of Cataract and Refractive Surgery)

Visual Acuity Chart

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

(Source: Journal of Cataract and Refractive Surgery)

Journal of Cataract and Refractive Surgery — Mon, 01 Mar 2010 00:00:00 +0100

(Source: Journal of Cataract and Refractive Surgery)

Combined surgery or trabeculectomy alone for patients with uncontrollable PACG

Optometry - Journal of the American Optometric Association — Mon, 01 Mar 2010 00:00:00 +0100

Primary angle closure glaucoma (PACG) is a debilitating, sight-threatening disease that is commonly found in the Asian population. Although initial treatment may be obtained with laser peripheral iridotomies, the patient more often than not will require additional surgeries, such as cataract extraction and/or a trabeculectomy to obtain adequate intraocular pressure (IOP) control. This retrospective study examined the long-term efficacy and safety of cataract surgery in conjunction with trabeculectomy versus trabeculectomy alone. (Source: Optometry - Journal of the American Optometric Association)

Expedited Cataract Surgery Doesn't Reduce Falls

Internal Medicine News — Mon, 01 Mar 2010 00:00:00 +0100

Major Finding: Fewer falls occurred after expedited cataract surgery (76 out of 274 patients), compared with standard surgery (87 out of 271 patients), but the difference was not significant. (Source: Internal Medicine News)

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Hormone Therapy Associated With Need for Cataract Surgery

Ob.Gyn. News — Mon, 01 Mar 2010 00:00:00 +0100

Major Finding: Women who had ever used hormone therapy had a 14% higher risk for cataract extraction and current HT users had an 18% higher risk, compared with women who never used HT. (Source: Ob.Gyn. News)

Past, Present, and Future of Ophthalmic Surgery

Ophthalmology — Fri, 26 Feb 2010 15:06:32 +0100

The past, present, and future of ophthalmic surgery is found in both the Letter to the Editor by Harry H. Mark, MD, in “History of Ophthalmology” and the article “Robot-assisted vitreoretinal surgery: development of a prototype and feasibility studies in an animal model” by Taskashi Ueta, MD, et al in the August 2009 issue of Ophthalmology. Note there are innovative videos accompanying this article in the electronic edition. Great strides are being made in robot-assisted surgery such as fine computerized motor skills that dampens the surgeon's microtremors, enhanced 3-dimensional views, tactile feel, remote access, etc. How long will it be before cataract and retinal surgery may be done remotely? Presently we use computer models for training and assessing surgery in wet labs. (Sour...

Peribulbar anesthesia for cataract surgery: Effect of lidocaine warming and alkalinization on injection pain, motor and sensory nerve blockade

Indian Journal of Ophthalmology — Fri, 26 Feb 2010 15:05:53 +0100

Conclusion:</b> Alkalinized lidocaine with or without warming produced less pain than lidocaine injected at room temperature. Alkalinization enhances the effect of warming for sensory nerve blockade, but warming does not enhance alkalinization, in fact it reduces the efficacy of alkalinized solution for blocking the motor nerves in the eye. (Source: Indian Journal of Ophthalmology)

Visual outcome of pars plana vitrectomy with intraocular foreign body removal through sclerocorneal tunnel and sulcus-fixated intraocular lens implantation as a single procedure, in cases of metallic intraocular foreign body with traumatic cataract

Indian Journal of Ophthalmology — Fri, 26 Feb 2010 15:05:53 +0100

Conclusion:</b> Primary IOL implantation with combined cataract and vitreo-retinal surgery is a safe option reducing the need for two separate surgeries in selected patients with retained IOFB and traumatic cataract. This combined procedure provides good visual outcome with early rehabilitation in young working patients. (Source: Indian Journal of Ophthalmology)

Advances in intraocular lenses for cataract surgery: A review

Indian Journal of Ophthalmology — Fri, 26 Feb 2010 15:05:53 +0100

Sinha Rajesh, Sachdev Ritika, Sharma Namrata, Titiyal Jeewan SIndian Journal of Ophthalmology 2010 58(2):177-182 (Source: Indian Journal of Ophthalmology)

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Missed intraocular foreign body masquerading as intraocular inflammation: two cases

International Ophthalmology — Fri, 26 Feb 2010 09:42:59 +0100

Abstract To report two cases with missed intraocular foreign body masquerading as intraocular inflammation. The first patient was referred to our clinic with a diagnosis of a traumatic cataract. She had a history of ocular trauma. The clinical examination revealed intraocular inflammation and a mature cataract. Plain X-ray did not reveal a foreign body. She underwent a successful cataract surgery and intraocular lens implantation 1 month after the initial examination. Two months after the surgery she returned with visual impairment and intraocular inflammation. The foreign body was discovered on the surface of the iris during the follow-up. The second patient was referred to us for endophthalmitis. He denied ocular trauma. Plain X-ray, computerized tomography, and ul...

Anesthesiologist intervention during cataract surgery under topical or peribulbar anesthesia: a propensity model comparison.

European Journal of Ophthalmology — Thu, 25 Feb 2010 00:00:00 +0100

Conclusions. Monitored anesthesia care is feasible for cataract surgery both under PA or TA. PA still remains an appealing alternative to TA during cataract surgery for patients incapable of keeping the operating eye in the primary position or with incoercible blinking, photophobia, or phacodonesis. A greater incidence of agitation is to be expected and adequate premedication with anxiolytics should be considered if PA is chosen. PMID: 20213615 [PubMed - as supplied by publisher] (Source: European Journal of Ophthalmology)

Recalcitrant fungal tunnel infection treated with intrastromal injection of voriconazole

International Ophthalmology — Wed, 24 Feb 2010 06:50:32 +0100

Abstract We are reporting a case of recalcitrant fungal tunnel infection treated with intrastromal injection of voriconazole. A 50-year-old woman underwent an uneventful phacoemulsification through a temporal corneal tunnel incision for age-related cataract in her right eye. One month post-surgery, she developed tunnel infection. Microbiological investigations revealed Aspergillus flavus as the offending pathogen. Despite intensive medical treatment, the corneal and anterior chamber infiltrate progressively enlarged. At the end of three and a half weeks, 0.1 ml of 0.05% voriconazole was injected intra-stromally surrounding the central end of the corneal infiltrate. On the subsequent follow-ups, a gradual improvement was noted and slowly it resolved completely. Top...

Non-Syndromic Supernumerary Caruncles Causing Ocular Irritation After Cataract Surgery: A Critical Review of Caruncular Dysgeneses

American Journal of Ophthalmology — Sat, 20 Feb 2010 15:05:03 +0100

Conclusions: A literature review confirms that supernumerary (extra) caruncles coexisting with a normal caruncle are always unilateral and unassociated with any other ocular anomalies, as in the current case. They may, however, cause ocular irritation. They must be distinguished from ectopic (topographically displaced) or dysplastic caruncles that are generally bilateral and often associated with ocular adnexal abnormalities or Goldenhar syndrome. Ectopic or dysplastic caruncles, but not supernumerary ones, are characteristically accompanied by plical abnormalities or its absence. Well-documented supernumerary and ectopic caruncles have always been located in the inferior palpebral conjunctiva. (Source: American Journal of Ophthalmology)

A review of clinical trials of anti-VEGF agents for diabetic retinopathy

Graefe's Archive for Clinical and Experimental Ophthalmology — Sat, 20 Feb 2010 06:50:18 +0100

Conclusions For diabetic macular edema, phase II trials of intravitreal pegaptanib and intravitreal ranibizumab have shown short-term benefit in visual acuity. Intravitreal bevacizumab also has been shown to have beneficial short-term effects on both visual acuity and retinal thickness. For proliferative diabetic retinopathy (PDR), early studies suggest that intravitreal bevacizumab temporarily decreases leakage from diabetic neovascular lesions, but this treatment may be associated with tractional retinal detachment (TRD). Furthermore, several studies indicate that bevacizumab is likely to prove a helpful adjunct to diabetic pars plana vitrectomy (PPV) for TRD. Finally, three small series suggest a potential beneficial effect of a single dose of bevacizumab to prevent wor...

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Interventions for preventing posterior capsule opacification.

Cochrane Database of Systematic Reviews — Sat, 20 Feb 2010 04:58:05 +0100

CONCLUSIONS: Due to the highly significant difference between round and sharp edged IOL optics, IOLs with sharp (posterior) optic edges should be preferred. There is no clear difference between optic materials. The choice of postoperative anti-inflammatory treatment does not seem to influence PCO development. PMID: 20166069 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

A survey on the use of general anesthesia for cataract surgery

Graefe's Archive for Clinical and Experimental Ophthalmology — Tue, 16 Feb 2010 18:06:15 +0100

Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s00417-010-1314-0Authors Christine K. Chen, VA Medical Center Section of Ophthalmology Providence RI 02908-4799 USAVictoria L. Tseng, VA Medical Center Section of Ophthalmology Providence RI 02908-4799 USAWen-Chih Wu, VA Medical Center Medicine Service Providence RI USAPaul B. Greenberg, VA Medical Center Section of Ophthalmology Providence RI 02908-4799 USA Journal Graefe's Archive for Clinical and Experimental OphthalmologyOnline ISSN 1435-702XPrint ISSN 0721-832X (Source: Graefe's Archive for Clinical and Experimental Ophthalmology)

Visual results and complications of primary intraocular lens implantation in infants aged 6 to 12 months

Graefe's Archive for Clinical and Experimental Ophthalmology — Tue, 16 Feb 2010 18:06:14 +0100

Conclusions Primary IOL implantation was safe and effective for infantile cataract surgery. Total or unilateral cataract, nystagmus or strabismus, and inadequate amblyopic therapy were predictors of poor BCVA. Significant myopic shifts occurred especially in infants in the first year of surgery. The pseudophakic eye had a similar growth rate, as measured by axial length, to that of the fellow normal eye, in unilateral cases. Content Type Journal ArticleCategory CataractDOI 10.1007/s00417-010-1310-4Authors Yi Lu, Fudan University Department of Ophthalmology, Eye & ENT Hospital 83 Fenyang Road Shanghai 200031 ChinaYing-Hong Ji, Fudan University Department of Ophthalmology, Eye & ENT Hospital 83 Fenyang Road Shanghai 200031 ChinaYi Luo, Fudan University Department of ...

Visual outcomes 12 months after phacoemulsification cataract surgery in patients with diabetes

Acta Ophthalmologica — Tue, 16 Feb 2010 00:00:00 +0100

Purpose: To assess cataract surgery visual outcomes 12 months postoperatively in patients with diabetes, with or without diabetic retinopathy (DR), compared to patients without diabetes.Methods: We followed 1192 cataract surgical patients aged [ge]65 for 12 months postoperatively. Standardised pre- and postoperative pinhole LogMAR visual acuity (VA) measurements were taken. Mean VA improvement was determined by comparing VA after 12 months to preoperative VA.Results: Of 1192 surgical patients, 324 (27.2%) had diabetes, of whom, 136 (42.0%) had DR. After adjusting for age, gender, diabetes duration and preoperative pinhole VA, the average VA gained 12 months after surgery was 10.8 letters among 868 patients without diabetes, 10.6 letters among 188 patients with diabetes but no DR, 10.0 lett...

Can we meet the future demands for cataract surgery?

Acta Ophthalmologica — Tue, 16 Feb 2010 00:00:00 +0100

(Source: Acta Ophthalmologica)

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Small Heat Shock Proteins and Protein-Misfolding Diseases.

Current Pharmaceutical Biotechnology — Tue, 16 Feb 2010 00:00:00 +0100

Authors: Laskowska E, Matuszewska E, Kuczyńska-Wiśnik D Small heat shock proteins (sHsps) are molecular chaperones ubiquitously distributed in numerous species, from bacteria to humans. A conserved C-terminal "alpha-crystallin" domain organized in a beta-sheet sandwich and oligomeric structure are common features of sHsps. sHsps protect cells against many kinds of stresses including heat shock, oxidative and osmotic stress. sHsps recognize unfolded proteins, prevent their irreversible aggregation and facilitate refolding of bound substrates in cooperation with ATP-dependent molecular chaperones (Hsp70/Hsp40). Mammalian sHsps (HSPBs) are multifunctional proteins involved in many cellular processes including those which are not directly related to protein folding and aggregat...

Effects of intracameral use of adrenalin solution with preservative on corneal endothelium.

Cutaneous and Ocular Toxicology — Mon, 15 Feb 2010 06:12:10 +0100

Conclusions: Intracameral injection of 1:100,000 dilution adrenalin with sodium bisulfite preservative is not toxic to corneal endothelium. PMID: 20148736 [PubMed - in process] (Source: Cutaneous and Ocular Toxicology)

Hormone Therapy Tied to Cataract Surgery

Internal Medicine News — Mon, 15 Feb 2010 00:00:00 +0100

Women who used hormone therapy were more likely to need cataract surgery, a risk potentiated by drinking alcohol, a large Swedish prospective study found. In a 98-month study of 30,861 postmenopausal women, those who had ever used hormone therapy (HT) had a 14% higher risk for cataract extraction and current HT users had an 18% higher risk, compared with women who never used HT in a multivariate analysis, Dr. Birgitta Ejdervik Lindblad and her associates reported (Ophthalmology 2010 Jan. 4 [doi:10.1016/j.ophtha.2009.07.046]). (Source: Internal Medicine News)

Hormone Therapy Associated With Need for Cataract Surgery

Family Practice News — Mon, 15 Feb 2010 00:00:00 +0100

Women who used hormone therapy were more likely to need cataract surgery, a risk potentiated by drinking alcohol, a large Swedish prospective study found. In a 98-month study of 30,861 postmenopausal women, those who had ever used hormone therapy (HT) had a 14% higher risk for cataract extraction and current HT users had an 18% higher risk, compared with women who never used HT in a multivariate adjusted analysis, Dr. Birgitta Ejdervik Lindblad and her associates reported (Ophthalmology doi:10.1016/j.ophtha.2009.07.046). (Source: Family Practice News)

Expedited Cataract Surgery Doesn't Reduce Falls

Family Practice News — Mon, 15 Feb 2010 00:00:00 +0100

Major Finding: Fewer falls occurred after expedited surgery (76 out of 274 patients), compared with standard surgery (87 out of 271 patients), for an OR of 0.81; the result did not reach significance (CI 0.55-1.17). (Source: Family Practice News)

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Vision improvement and reduction in falls after expedited cataract surgery Systematic review and metaanalysis. - Desapriya E, Subzwari S, Scime-Beltrano G, Samayawardhena LA, Pike I.

SafetyLit: All (Unduplicated) — Sat, 13 Feb 2010 15:31:42 +0100

PURPOSE: To quantify the benefits of expedited cataract surgery in improving visual acuity and reducing fall-related injuries in the older population. SETTING: Developmental Neurosciences and Child Health: Neurons to Neighbourhoods, Vancouver, British Colu... (Source: SafetyLit: All (Unduplicated))

The Duke-Elder undergraduate prize in opthalmology

Fri, 12 Feb 2010 15:30:59 +0100

An undergraduate prize examination will be sponsored again this year on a national basis by The Royal College of Ophthalmologists. This examination is intended for medical students who have completed their ophthalmology undergraduate teaching, but it is open to all medical undergraduates provided they have not graduated at the time of the examination. Students may sit the examination on more than one occasion provided they have not yet graduated and have not previously won the prize. There will be a cash prize of £400 for the candidate gaining the highest mark. If there is more than one candidate gaining the highest mark this amount will be split respectively. There is no second prize. The 90 minute examination consists of: 15, three stem Extended Matching Questions (EMQ) 20 Multip...

Nonsteroidal Anti-inflammatory Drugs in Ophthalmology

Survey of Ophthalmology — Fri, 12 Feb 2010 14:52:53 +0100

Abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are increasingly employed in ophthalmology to reduce miosis and inflammation, manage scleritis, and prevent and treat cystoid macular edema associated with cataract surgery. In addition, they may decrease postoperative pain and photophobia associated with refractive surgery and may reduce the itching associated with allergic conjunctivitis. In recent years, the U.S. Food and Drug Administration has approved new topical NSAIDs, and previously approved NSAIDs have been reformulated. These additions and changes result in different pharmacokinetics and dosing intervals, which may offer therapeutic advantages. For example, therapeutic effects on diabetic retinopathy and age-related macular degeneration may now be achievable. We provide an ...

Use of 5-Fluorouracil Injections to Reduce the Risk of Trabeculectomy Bleb Failure After Cataract Surgery

Journal of Ocular Pharmacology and Therapeutics — Thu, 11 Feb 2010 17:57:16 +0100

Journal of Ocular Pharmacology and Therapeutics , Vol. 0, No. 0. (Source: Journal of Ocular Pharmacology and Therapeutics)

Rate of Endophthalmitis After Cataract Surgery in Quebec, Canada, 1996-2005 [Epidemiology]

Archives of Opthalmology — Mon, 08 Feb 2010 20:51:02 +0100

Conclusion Reasons that explain the apparent decrease in endophthalmitis, especially in 2005, should be explored and further research performed to understand why certain patients and regions have higher risks of endophthalmitis after cataract surgery. (Source: Archives of Opthalmology)

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[Correction of corneal astigmatism with toric lenses : Theory and clinical aspects.]

Der Ophthalmologe — Sun, 07 Feb 2010 00:00:00 +0100

Authors: Langenbucher A, Viestenz A, Szentmáry N, Viestenz A, Eppig T, Seitz B In the last decades, the implantation of pseudophakic and phakic toric lenses has become widespread for correcting corneal astigmatism: in cataract surgery cases with implantation of a posterior chamber lens and in refractive surgery cases with implantation of phakic lenses. The purpose of this educational and training article is to familiarize the reader with the application of pseudophakic and phakic toric lenses, to show which parameters are necessary for calculating toric lenses, to present a matrix-based calculation scheme for pseudophakic and phakic toric lenses, to explicitly demonstrate the step-by-step calculations with clinical examples, and to show the impact of lens dislocation (especially r...

Limbal relaxing incision during cataract extraction versus photoastigmatic keratectomy after cataract extraction in controlling pre-existing corneal astigmatism

Graefe's Archive for Clinical and Experimental Ophthalmology — Fri, 05 Feb 2010 17:53:27 +0100

Conclusions PAK is more effective than LRI in the control of pre-existing manifest astigmatism. LRI causes less accentuation of the spherical HOAs than PAK. Content Type Journal ArticleCategory Refractive SurgeryDOI 10.1007/s00417-009-1272-6Authors Sameh Fouda, Zagazig University Department of Ophthalmology, Faculty of Medicine Zagazig, Sharkia EgyptKazutaka Kamiya, Kitasato University Department of Ophthalmology Sagamihara, Kanagawa JapanDaisuke Aizawa, Kitasato University Department of Ophthalmology Sagamihara, Kanagawa JapanKimiya Shimizu, Kitasato University Department of Ophthalmology Sagamihara, Kanagawa Japan Journal Graefe's Archive for Clinical and Experimental OphthalmologyOnline ISSN 1435-702XPrint ISSN 0721-832X (Source: Graefe's Archive for Clinical...

[Technologies, techniques and tactics for micro-incision cataract surgery.]

Der Ophthalmologe — Fri, 05 Feb 2010 00:00:00 +0100

Authors: Fabian E, Maier M Ultra-sound (US) phaco-emulsification is currently developing from a small incision to a micro-incision cataract surgery (MICS). Improvements in machine technologies with new US delivery modes with better control of irrigation and aspiration, with smaller phacotips and sleeves and with new intraocular lenses and injector systems for implantations through incisions less than 2 mm wide. Therefore, the most suitable method for surgery can be selected for each individual eye situation. Further improvements of intra-ocular lenses for implantation through incisions less than 2 mm wide would be desirable. PMID: 20130886 [PubMed - as supplied by publisher] (Source: Der Ophthalmologe)

Computer Simulation Tool Supplements Residents' Training In Cataract Surgery

Health News from Medical News Today — Thu, 04 Feb 2010 08:00:00 +0100

The Massachusetts Eye and Ear Infirmary Cataract Surgery Trainer, a virtual training tool which helps to train physicians to perform cataract surgery, has been shown to enhance teaching in cataract surgery when compared to traditional teaching methods. The results of a multi-center study evaluating the program's effectiveness as a supplement to traditional teaching tools was published in the February issue of Ophthalmology. Cataract surgery is the most frequently performed surgery in the United States on people over 65 years old, yet it is one of the most difficult surgeries to learn... (Source: Health News from Medical News Today)

Computer Simulation Tool Supplements Residents' Training In Cataract Surgery

IT / Internet / E-mail News From Medical News Today — Thu, 04 Feb 2010 08:00:00 +0100

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David F. Chang (ed): Curbside Consultation in Cataract Surgery

Graefe's Archive for Clinical and Experimental Ophthalmology — Wed, 03 Feb 2010 17:55:46 +0100

Content Type Journal ArticleCategory Book ReviewDOI 10.1007/s00417-009-1280-6Authors Shimon Rumelt, Western Galilee–Nahariya Medical Center Department of Ophthalmology Nahariya Israel Journal Graefe's Archive for Clinical and Experimental OphthalmologyOnline ISSN 1435-702XPrint ISSN 0721-832X (Source: Graefe's Archive for Clinical and Experimental Ophthalmology)

Podcast: Terry Kim, MD, on Duke Eye Center

DukeHealth.org: Duke Health Features — Wed, 03 Feb 2010 15:19:12 +0100

In this podcast, Terry Kim MD, Associate Director, Cornea and Refractive Surgery Services, answers questions about Duke Eye Center’s vision correction options using LASIK and cataract surgery. Listen to the Podcast (Download audio) Podcast Transcript Announcer: Our first guest tonight is Dr. Terry Kim, who is a refractive surgery specialist over at the Duke Eye Center, and he's the ophthalmology consultant for the Duke men's basketball team. Terry thanks a lot for joining us. First of all maybe you could tell us what you do as the official team eye doctor? Dr. Kim: John, first of all thank you for having me. I went to college and medical school here and I've been listening to you for 12 years and it's great to be here on your radio show. Basically how this happen was, back about 199...

Inferior rectus paresis and medial rectus overaction following retrobulbar anesthesia for cataract surgery

International Ophthalmology — Wed, 03 Feb 2010 06:49:58 +0100

Abstract Strabismus is a well recognized complication of retrobulbar anesthesia for cataract surgery. This may manifest as either paresis or sometimes contracture (overaction) in the late stage. Management of the patient is tailored to the individual case. Herein, we report a patient with inferior rectus paresis and medial rectus overaction after retrobulbar anesthesia. The presenting symptom was diplopia increasing on downgaze, which improved with medial rectus recession and plication of the inferior rectus. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10792-010-9342-7Authors R. Muralidhar, Aravind Eye Hospital Madurai IndiaP. Vijayalakshmi, Aravind Eye Hospital Madurai IndiaAnil K. Gunda, Aravind Eye Hospital Madurai India Journal International O...

Mass. Eye and Ear Infirmary Cataract Surgery Trainer teaches residents cataract surgery

EurekAlert! - Medicine and Health — Tue, 02 Feb 2010 05:00:00 +0100

(Massachusetts Eye and Ear Infirmary) The Massachusetts Eye and Ear Infirmary Cataract Surgery Trainer, a virtual training tool which helps to train physicians to perform cataract surgery, has been shown to enhance teaching in cataract surgery when compared to traditional teaching methods. The results of a multi-center study evaluating the program's effectiveness as a supplement to traditional teaching tools was published in the February issue of Ophthalmology. (Source: EurekAlert! - Medicine and Health)

Evaluation of the analgesic effect of intracameral lidocaine hydrochloride injection on intraoperative and postoperative pain in healthy dogs undergoing phacoemulsification.

American Journal of Veterinary Research — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions and Clinical Relevance-Intracameral lidocaine injection had significant analgesic effects in dogs undergoing cataract surgery. Results of this study suggest the value of intracameral lidocaine injection as an analgesic for intraocular surgery in dogs. PMID: 20113230 [PubMed - in process] (Source: American Journal of Veterinary Research)

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