MedWorm: Cataract Removal

AAO, ASCRS offer guidance on femtosecond billing

Modern Medicine — Wed, 08 Feb 2012 05:00:00 +0100

The American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery have issued guidelines to assist ophthalmologists in determining their ability to charge Medicare and/or its beneficiaries for use of a femtosecond laser during cataract surgery. (Source: Modern Medicine)

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How to Improve Refractive Outcomes After Cataract SurgeryHow to Improve Refractive Outcomes After Cataract Surgery

Medscape Today Headlines — Fri, 03 Feb 2012 21:56:39 +0100

What do you do when the refractive outcome after cataract surgery does not meet your target? Dr. Roger Steinert offers advice on how to best manage these cases and fine-tune the results. Medscape Ophthalmology (Source: Medscape Today Headlines)

Safety of Prophylactic Intracameral Moxifloxacin Use in Cataract Surgery

Journal of Ocular Pharmacology and Therapeutics — Fri, 03 Feb 2012 14:48:49 +0100

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

Consent for cataract surgery training: a national trainers’ survey

Eye — Fri, 03 Feb 2012 08:00:00 +0100

Consent for cataract surgery training: a national trainers’ survey Eye advance online publication, February 3, 2012. doi:10.1038/eye.2012.2 Authors: L Steeples, K Mercieca & K Smyth (Source: Eye)

Changes in the tear film and ocular surface after cataract surgery

Japanese Journal of Ophthalmology — Thu, 02 Feb 2012 06:56:38 +0100

Conclusions The decrease in GCD, which was correlated with operative time, had not recovered at 3 months after cataract surgery. Therefore, microscopic ocular surface damage during cataract surgery seems to be one of the pathogenic factors that cause ocular discomfort and dry eye syndrome after cataract surgery. Content Type Journal ArticleCategory Clinical InvestigationPages 1-6DOI 10.1007/s10384-012-0117-8Authors Taehoon Oh, Department of Ophthalmology and Visual Science, St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713 KoreaYounhea Jung, Department of Ophthalmology and Visual Science, St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #62 Yeouido-dong, Y...

Long‐term outcomes of phacoemulsification cataract surgery performed by trainees and consultants in an Australian cohort

Clinical and Experimental Ophthalmology — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions: We found relatively comparable complication rates and visual outcomes after 2 years between patients operated on by ophthalmological trainees and those by consultants, in a cataract surgical cohort at Westmead Hospital.© 2012 The Authors. Journal compilation © 2012 Royal Australian and New Zealand College of Ophthalmologists (Source: Clinical and Experimental Ophthalmology)

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Willingness to pay for potential enhancements to a low‐cost cataract surgical package in rural southern China

Acta Ophthalmologica — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Opportunities exist to increase cataract programme revenues through multi‐tiered offerings in this setting, allowing greater subsidization of low‐income patients. Personal familiarity with cataract surgery is important in determining WTP. (Source: Acta Ophthalmologica)

Preop evaluation before refractive IOL implantation

Modern Medicine — Wed, 01 Feb 2012 05:00:00 +0100

Preoperative evaluation of patients scheduled to undergo implantation of a refractive IOL is mandatory for obtaining the best postoperative results. Topography, optical coherence tomography of the macula, and fluorescein staining of the cornea are critical when evaluating patients before cataract surgery. William Trattler, MD, in private practice in Miami, described how he manages these patients. (Source: Modern Medicine)

Resident Cataract Surgery

Ophthalmology — Wed, 01 Feb 2012 05:00:00 +0100

We are writing regarding the recent report by Woodfield et al about resident cataract surgery complication rates. We definitely agree that it provides useful information that we might apply to our Ophthalmology Residency Training Program. However, it is also true that the results provided in this article are rather controversial. (Source: Ophthalmology)

NHS panel defines rules for rationing decisions

HealthcareRepublic Pharmacist News — Mon, 30 Jan 2012 00:01:00 +0100

Cataract surgery, knee replacement and other 'low clinical value' treatments must only be restricted on the basis of strict evidence-based criteria, an NHS panel has warned. (Source: HealthcareRepublic Pharmacist News)

Antioxidant Capacity of Lenses with Age-Related Cataract

Anesthesiology Research and Practice — Sun, 29 Jan 2012 12:15:47 +0100

The immediate cause of the occurrence of cataract is unknown, but oxidative damage and effects of reactive oxygen species are considered important in its etiopathogenesis. Our research was aimed at testing the nonenzyme antioxidant power of corticonuclear lens blocks, with different types and different maturity of age-related cataract. Clinical and biochemical researches were carried out in 101 patients with age-related cataract. In corticonuclear lens blocks of the patient, the concentration of nonprotein and total-SH groups and the concentration of total vitamin C and dehydroascorbic acid (DHA) were determined; the current redox balance of dehydroascorbate/ascorbate and total antioxidant power measured by ferric-reducing ability were examined. In corticonuclear lens blocks with incipient...

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Surgical outcome of Descemet’s stripping automated endothelial keratoplasty for bullous keratopathy secondary to argon laser iridotomy

Graefe's Archive for Clinical and Experimental Ophthalmology — Fri, 27 Jan 2012 17:54:24 +0100

Conclusions Descemet’s stripping automated endothelial keratoplasty for BK secondary to ALI showed rapid postoperative visual improvement, with similar efficacy and safety to that observed in DSAEK for PBK or FED. Content Type Journal ArticleCategory CorneaPages 1-8DOI 10.1007/s00417-012-1927-6Authors Masatoshi Hirayama, Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba 272-8513, JapanTakefumi Yamaguchi, Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba 272-8513, JapanYoshiyuki Satake, Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba 272-8513, JapanJun Shimazaki, Department of Ophthal...

Excimer laser refractive surgery versus phakic intraocular lenses for the correction of moderate to high myopia.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: The results of this review suggest that phakic IOLs are safer than excimer laser surgical correction for moderate to high myopia in the range of -6.0 to -20.0 D and phakic IOLs are preferred by patients. While phakic IOLs might be accepted clinical practice for higher levels of myopia (greater than or equal to 7.0 D of myopic spherical equivalent with or without astigmatism), it may be worth considering phakic IOL treatment over excimer laser correction for more moderate levels of myopia (less than or equal to 7.0 D of myopic spherical equivalent with or without astigmatism). Further RCTs adequately powered for subgroup analysis are necessary to further elucidate the ideal range of myopia for phakic IOLs. PMID: 22258972 [PubMed - in process] (Source: Cochrane Database of S...

Japan Approves New Device for Eye SurgeryJapan Approves New Device for Eye Surgery

Medscape Today Headlines — Tue, 24 Jan 2012 22:34:23 +0100

Japan’s Ministry of Health, Labour, and Welfare has approved a new device that enables simultaneous cataract and vitreoretinal surgery. Medscape Medical News (Source: Medscape Today Headlines)

23-gauge transconjunctival sutureless vitrectomy in treatment of post-operative endophthalmitis

Graefe's Archive for Clinical and Experimental Ophthalmology — Tue, 24 Jan 2012 07:53:14 +0100

Conclusion 23-G TSV allows the surgeon to meet the same objectives as the 20-G technique for the treatment of endophthalmitis. Content Type Journal ArticleCategory Inflammatory DisordersPages 1-5DOI 10.1007/s00417-012-1926-7Authors Ahmed M. Almanjoumi, Department of Ophthalmology, CHU de Grenoble, University Hospital, University Joseph Fourier, 38043 Grenoble Cedex 09, FranceAurélie Combey, Department of Ophthalmology, CHU de Grenoble, University Hospital, University Joseph Fourier, 38043 Grenoble Cedex 09, FranceJean Paul Romanet, Department of Ophthalmology, CHU de Grenoble, University Hospital, University Joseph Fourier, 38043 Grenoble Cedex 09, FranceChristophe Chiquet, Department of Ophthalmology, CHU de Grenoble, University Hospital, University Joseph Fourier, 38...

Results at seven years after the use of Intracamerular cefazolin as an endophthalmitis prophylaxis in cataract surgery

BMC Ophthalmology - Latest articles — Tue, 24 Jan 2012 05:00:00 +0100

Background: To evaluate results after seven years using prophylactic intracameral cefazolin for the prevention of endophthalmitis in cataract surgery. Methods: A prospective, observational study of all patients submitted to cataract surgery over the period January 1996 to December 2009. All cases of postoperative endophthalmitis over that period were reviewed. The patients were classified in two groups: Group 1 (11,696 patients) operated on between January 1996 and December 2002, Group 2 (13,305 patients) between January 2003 and December 2009 (in whom a 1mg/0.1 bolus of intracameral cefazolin was instilled). Results: During the study period, 76 cases of endophthalmitis were observed in Group 1, and seven in Group 2. The rate of postoperative endophthalmitis reduced from 0.63% to 0.05% wit...

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Vision improves modestly in patients after human embryonic stem cells transplants

UCLA Newsroom: Health Sciences — Mon, 23 Jan 2012 22:00:32 +0100

Researchers at UCLA's Jules Stein Eye Institute and colleagues who successfully transplanted specialized retinal cells derived from human embryonic stem cells into the eyes of two legally blind patients report that the transplants appear safe and that both patients have experienced modest improvement in their vision. The preliminary findings, published online Jan. 23 in the journal The Lancet, represent a milestone in the therapeutic use of stem cells and may pave the way for a new therapy to treat eye diseases, the researchers said. Because this is the first time physicians have applied the power of regenerative medicine to eye disease, the clinical trials are being watched closely by scientists, stem-cell therapy advocates and the public. The patients — a woman in her...

Vision improves modestly in patients after human embryonic stem cell transplants

UCLA Newsroom: Health Sciences — Mon, 23 Jan 2012 22:00:32 +0100

Combined Anterior Sclera Staphylectomy and Vitrectomy with Anterior Sclera Staphyloma and Vitreous Hemorrhage Occurring 38 Years after Cataract Surgery

Clinical and Developmental Immunology — Mon, 23 Jan 2012 11:22:21 +0100

Conclusions. This is the first reported case of anterior sclera staphyloma with vitreous hemorrhage successfully managed by combined surgery. (Source: Clinical and Developmental Immunology)

Twelve‐year Incidence of Exfoliation Syndrome in the Reykjavik Eye Study

Acta Ophthalmologica — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions: Twelve‐year incidence of XFS is higher in women than in men and higher in older age groups than in younger ones. Most persons deemed on the slitlamp to be unilaterally affected have converted to bilateral over 12 years. Eyes with XFS at baseline were 3–4 times more likely to have cataract surgery during the 12 years. Our definition of definite XFS generally holds, while our definition of probable XFS is of no prognostic value over 12 years. (Source: Acta Ophthalmologica)

Associations of early age‐related macular degeneration with ocular and general parameters. The central India eyes and medical study

Acta Ophthalmologica — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions: Hyperopia (and short axial length) besides age was the single most important associated factor for AMD in adult Indians. (Source: Acta Ophthalmologica)

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Effects of antioxidant supplementation on mRNA expression of glucose-6-phosphate dehydrogenase, β-actin and 18S rRNA in the anterior capsule of the lens in cataract patients.

Experimental Eye Research — Fri, 20 Jan 2012 05:00:00 +0100

Authors: Hayashi R, Hayashi S, Arai K, Chikuda M, Obara Y Abstract This was a preliminary study of the effects of antioxidant supplementation on the peroxidation status of the lens by investigating mRNA expression of anti-oxidative enzymes in the lens. The mRNA expression levels of glucose-6-phosphate dehydrogenase (G6PDH), β-actin (β-ACT) and 18S rRNA (18S) were measured in this study because they are common reference genes for measuring mRNA levels by means of a real-time reverse transcription polymerase chain reaction (RT-PCR) in various tissues. Thirteen patients with binocular cataracts of the same grade were included in the study after giving informed consent. A piece of the anterior capsule, along with a sample of lenticular epithelial cells (LECs), was collected as a pre-...

Effect of Ramadan fasting in tropical summer months on ocular refractive and biometric characteristics

Clinical and Experimental Optometry — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions: Ramadan fasting is associated with statistically significant alterations in anterior chamber depth and axial length that result in both statistically and clinically significant changes in intraocular lens power calculations. Therefore, relying on measurements taken during this month might lead to refractive errors after cataract surgery. (Source: Clinical and Experimental Optometry)

Elective surgery – low value?

NHS Networks — Fri, 13 Jan 2012 05:00:00 +0100

The aim of this report has been to make recommendations for consideration by the NHS Operations Board with regard to effective commissioning of elective surgical procedures. The work was commissioned by Professor Sir Bruce Keogh, NHS medical director, following widespread expressions of concern from professional bodies that approaches based on lists of procedures deemed to be of “limited effectiveness”, “low value” or requiring a “threshold” result in inequitable patterns of service delivery. The evidence base for such approaches is not thought to be sufficiently robust, and in many cases procedures with well-established evidence of effectiveness, such as cataracts or arthroplasty, have been included. (Source: NHS Networks)

Controlled clinical trial comparing biaxial microincision with coaxial small incision for cataract surgery.

European Journal of Ophthalmology — Fri, 13 Jan 2012 05:00:00 +0100

Conclusions. Compared to the standard small incision technique, B-MICS showed earlier improvement in BCVA, better overall UCVA, less SIA, and less endothelial cell loss. PMID: 22267455 [PubMed - as supplied by publisher] (Source: European Journal of Ophthalmology)

Patient satisfaction and postoperative pain with different postoperative therapy regimens after standardized cataract surgery: a randomized intraindividual comparison

International Ophthalmology — Mon, 09 Jan 2012 19:36:56 +0100

Abstract The purpose of this study was to evaluate if administration of artificial tears of high or low-viscosity improve cataract patients’ satisfaction and postoperative pain after cataract surgery. Thirty consecutive patients undergoing bilateral cataract surgery under topical anesthesia were enrolled prospectively. Administration of the following postoperative therapies was randomized: for all participants, one eye was treated with “instant vision” (IV) therapy alone (IV-alone), i.e., this eye remained uncovered. In group 1 (n = 11), the second eye received IV therapy with Hylo-Comod® (HC) eye drops; in group 2 (n = 9), IV with Vidisic® (VS) eye drops; in group 3 (n = 10), an ointment bandage (OB). Postoperative satisfaction, pain sc...

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Clinical and Pathologic Characteristics of Biopsy-Proven Iris Melanoma: A Multicenter International Study [Clinical Sciences]

Archives of Opthalmology — Mon, 09 Jan 2012 05:00:00 +0100

Conclusions Iris melanomas were most likely to be brown and found in the inferior quadrants of patients with light irides. Typically small and unifocal, melanomas are commonly associated with angle blunting and spindle cell histopathology. This multicenter, Internet-based, international study successfully pooled data and extracted information on biopsy-proven melanoma of the iris. (Source: Archives of Opthalmology)

Capsule Membrane Suture Fixation of Decentered Sulcus Intraocular Lenses [Surgical Technique]

Archives of Opthalmology — Mon, 09 Jan 2012 05:00:00 +0100

Different surgical methods are used to fixate the subluxated sulcus intraocular lens (IOL) in the absence of in-bag fixation, ranging from iris and scleral suturing to optic capture of the IOL. A new technique, which we have termed capsule membrane suture fixation, provides an additional method for securing a subluxated or decentered sulcus-based IOL to the remnant capsule or a capsular membrane. This method can also be used in secondary surgery for fixation, repositioning, or removal and replacement of IOLs. In this technique, the IOL haptics are sutured to the fibrotic elements of the capsular membrane to center and secure the IOL to the capsular membrane and prevent complications associated with uveal touch. (Source: Archives of Opthalmology)

Cataract Surgery Is More Expensive When Done by ResidentsCataract Surgery Is More Expensive When Done by Residents

Medscape Today Headlines — Thu, 05 Jan 2012 23:25:52 +0100

At 1 center, the residents' learning curve added more than $8000/year per resident to the cost of cataract surgery. Medscape Medical News (Source: Medscape Today Headlines)

Lower reading levels benefit informed consent process

Modern Medicine — Wed, 04 Jan 2012 05:00:00 +0100

Informed consent sheets that are concise and written at lower reading comprehension levels, as well as videotaped presentations, work well in helping patients understand the risks, benefits, and treatment alternatives to cataract surgery, according to the results of a randomized, prospective study recently published in the Journal of Cataract and Refractive Surgery. (Source: Modern Medicine)

Latitude And Gender Influences Glaucoma Risk

Health News from Medical News Today — Tue, 03 Jan 2012 10:00:00 +0100

When it comes to whether or not you will develop exfoliation syndrome (ES) -- an eye condition that is a leading cause of secondary open-angle glaucoma and increased risk of cataract as well as cataract surgery complications -- age, gender and where you live does matter. "Although many studies from around the world have reported on the burden of the disease, some aspects of the basic descriptive epidemiologic features, which may help shed light on the cause, are inconsistent," said Louis Pasquale, M.D... (Source: Health News from Medical News Today)

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A Fully Human In Vitro Capsular Bag Model to Permit Intraocular Lens Evaluation [Lens]

Investigative Ophthalmology — Tue, 03 Jan 2012 05:00:00 +0100

Conclusions. The authors have developed a fully human in vitro capsular bag system that relates well to clinical observations and permits the testing of novel intraocular lenses. (Source: Investigative Ophthalmology)

Drill and Chop: Modified Vertical Chop Technique for Hard Cataract.

Sun, 01 Jan 2012 19:48:23 +0100

Authors: Kim DY, Jang JH Abstract The authors describe a technique to improve the control and safety of vertical chopping during hard cataract surgery. Whereas the conventional vertical chop technique uses a sharp vertical chopper, the proposed technique uses a short blunt chopper. This requires complete engagement of the central nucleus by a phaco tip. The authors first drilled a hole into the endonucleus. By rotating the Kelman phaco tip clockwise, the nucleus was deeply impaled horizontally and firmly engaged with the phaco tip. This was followed by vertical chopping. This technique results in safer and more effective vertical chopping in patients with hard cataracts. PMID: 22201524 [PubMed - as supplied by publisher] (Source: Ophthalmic Surgery, Lasers and Imaging : the Off...

Glaucoma Triggers May Include Temperatures, Sun Exposure and Gender

Disabled World — Sun, 01 Jan 2012 18:58:01 +0100

Outside temperatures, sun exposure and gender may trigger glaucoma - When it comes to whether or not you will develop exfoliation syndrome (ES), an eye condition that is a leading cause of secondary open-angle glaucoma and increased risk of cataract as well as cataract surgery complications, age, gender and where you live does matter. (Source: Disabled World)

Outside temperatures, sun exposure and gender may trigger glaucoma

EurekAlert! - Medicine and Health — Sun, 01 Jan 2012 05:00:00 +0100

(Massachusetts Eye and Ear Infirmary) When it comes to whether or not you will develop exfoliation syndrome -- an eye condition that is a leading cause of secondary open-angle glaucoma and increased risk of cataract as well as cataract surgery complications -- age, gender and where you live does matter. Find out more in the study, the "Demographic and Geographic Features of Exfoliation Glaucoma in two United States-Based Prospective Cohorts" are published in the January 2012 issue of Ophthalmology. (Source: EurekAlert! - Medicine and Health)

[Aphakic and pseudophakic glaucoma following pediatric cataract surgery].

Der Ophthalmologe — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Solebo AL, Rahi J, Grehn F Abstract Modern surgical techniques allow congenital cataract surgery to be performed much more successfully. The development of a secondary glaucoma is the most dreaded postoperative complication (one third of all pediatric secondary glaucomas). Due to the limited value of the available literature, data on prevalence are unreliable. A 10-year postoperative incidence of 10-25% is given in the literature for developing secondary glaucoma and the frequency increases with the duration of follow-up. A major risk factor seems to be the age at the time of surgery. The younger the patient is at the time of surgery the higher the risk of secondary glaucoma. A microcornea seems to be another risk factor in multivariate analysis. The following postoperativ...

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Phototherapeutic keratectomy

Indian Journal of Ophthalmology — Fri, 30 Dec 2011 05:00:00 +0100

Varsha M Rathi, Sharadini P Vyas, Virender S SangwanIndian Journal of Ophthalmology 2012 60(1):5-14Phototherapeutic keratectomy (PTK) is done regularly for anterior corneal diseases such as corneal dystrophies, corneal degenerations, scars, and band-shaped keratopathy. The various indications include both therapeutic and visual. The aim of this article is to discuss the therapeutic indications for PTK, the specific technique pertaining to a specific etiology, the various other procedures like amniotic membrane graft combined with PTK or PTK being done for recurrences in the grafts, and PTK done before cataract surgery when the anterior corneal pathology coexists with the cataract. Post PTK management such as healing of an epithelial defect, use of steroids in the post PTK period, recurrenc...

Comparison of different techniques of cataract surgery in bacterial contamination of the anterior chamber in diabetic and non-diabetic population

Indian Journal of Ophthalmology — Fri, 30 Dec 2011 05:00:00 +0100

Conclusion : Statistically significant reduction in conjunctival flora was achieved with topical ofloxacin and 5% PI instillation and AC contamination in both manual SICS and Phaco was minimal (0.66%). Well-controlled diabetics who underwent cataract surgery in this study had similar conjunctival flora and AC contamination as non-diabetics. (Source: Indian Journal of Ophthalmology)

The impact of gender on first eye cataract surgery and motor vehicle crash risk for older drivers. - Meuleners LB, Ng JQ, Fraser M, Hendrie D, Morlet N.

SafetyLit: All (Unduplicated) — Thu, 29 Dec 2011 04:51:29 +0100

Background: No study to date has examined gender differences in crash risk after cataract surgery. Therefore, this study aimed to determine gender-related differences in the effectiveness of first eye cataract surgery in reducing crash risk for older dr... (Source: SafetyLit: All (Unduplicated))

Preservation of corneal endothelium after pars plana tube insertion of the Ahmed glaucoma valve

Japanese Journal of Ophthalmology — Tue, 27 Dec 2011 16:50:56 +0100

Conclusions Corneal endothelial damage was minimal, and the success probability was relatively high after ppAGV in refractive glaucoma cases. Content Type Journal ArticleCategory Clinical InvestigationPages 1-9DOI 10.1007/s10384-011-0108-1Authors Etsuo Chihara, Sensho-kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto 611-0043, JapanMitsuyoshi Umemoto, Sensho-kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto 611-0043, JapanMasaki Tanito, Department of Ophthalmology, Shimane University, Faculty of Medicine, 89-1 Enya, Izumo, 693-8501 Japan Journal Japanese Journal of OphthalmologyOnline ISSN 1613-2246Print ISSN 0021-5155 (Source: Japanese Journal of Ophthalmology)

Prevention and Management of Cataracts in Children with Juvenile Idiopathic Arthritis–Associated Uveitis

Current Rheumatology Reports — Tue, 27 Dec 2011 06:33:53 +0100

Abstract Juvenile idiopathic arthritis (JIA)-associated uveitis can be associated with vision-compromising complications such as cataracts, glaucoma, synechiae, and band keratopathy. Of these, cataracts are one of the most common sequelae of JIA-associated uveitis and can result in significant visual disability. Risk factors for cataracts include posterior synechiae and longstanding ocular inflammation. Prevention of cataract development is crucial through appropriate control of uveitis. However, not all preventive measures are successful, and further management consisting of medical and surgical techniques is often necessary. Various factors should be taken into consideration when deciding on cataract management, including timing of surgery and placement of an intraocular...

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Benchmarking Cataract SurgeryBenchmarking Cataract Surgery

Medscape Today Headlines — Tue, 27 Dec 2011 05:53:41 +0100

Is it even possible to develop valid indicators for quality outcomes in cataract surgery? Medscape Ophthalmology (Source: Medscape Today Headlines)

Improved Refractive Outcome for Ciliary Sulcus-Implanted Intraocular Lenses

Ophthalmology — Mon, 26 Dec 2011 05:00:00 +0100

Conclusions: This is the first comparative clinical review examining adjustment of power of the sulcus-implanted IOL. We found that the IOL power should be adjusted according to the measured AL and predicted IOL power. For patients with a predicted IOL power from 18 to 25 D, power should be reduced by at least 1 D; for lenses >25 D, power should be reduced by 1.5 to 2 D. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. (Source: Ophthalmology)

Lens retrodots and vacuoles and their associations with the prevalence and incidence of age-related cataract

Eye — Fri, 23 Dec 2011 08:00:00 +0100

Authors: A G Tan, P Mitchell, E Rochtchina, T Hong, R G Cumming & J J Wang (Source: Eye)

Med Sci Monit 2012; 18(1):PI1-4 "Results of the AcrySof Toric intraocular lenses implantation"

Medical Science Monitor — Thu, 22 Dec 2011 19:17:00 +0100

Conclusions: We noticed clinically and statistically important vision acuity improvement in the corneal astigmatism patients. The patients’ high satisfaction was conditioned by proper pre-surgery qualification. Astigmatism correction by cataract removal surgery is a safe and effective surgical solution. In the future, we expect the use of toric intraocular lenses will become widespread and significant. (Source: Medical Science Monitor)

OptiMedica Receives FDA Market Clearance Of The Catalys Precision Laser System

Medical Design Online News — Thu, 22 Dec 2011 12:00:00 +0100

Global ophthalmic company OptiMedica Corp. has announced the U.S. Food and Drug Administration (FDA) 510(k) market clearance of its Catalys Precision Laser System, a next generation laser cataract surgery system that brings unequaled precision and accuracy and a markedly streamlined workflow to the laser cataract procedure (Source: Medical Design Online News)

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FDA Program Targets Rare Cataract Surgery ComplicationFDA Program Targets Rare Cataract Surgery Complication

Medscape Today Headlines — Thu, 22 Dec 2011 01:20:36 +0100

Several agencies are now working together to track cases of toxic anterior segment syndrome and improve device safety. Medscape Medical News (Source: Medscape Today Headlines)

FDA to Study Complication of Cataract Surgery

MedPage Today Public Health — Wed, 21 Dec 2011 19:16:15 +0100

WASHINGTON (MedPage Today) -- A rare but potentially serious complication of cataract surgery has caught the attention of the FDA, which has launched a monitoring program to prevent outbreaks of toxic anterior segment syndrome (TASS). (Source: MedPage Today Public Health)

FDA Collaborates To Work Against Rare Cataract Condition

Health News from Medical News Today — Wed, 21 Dec 2011 02:00:00 +0100

Toxic Anterior Segment Syndrome (TASS) is a rare condition that can occur after cataract surgery. The U.S. Food and Drug Administration in collaboration with other Government agencies, unveiled a program today to monitor medical devices used in cataract surgery in an effort to stem outbreaks of the rare, inflammatory condition... (Source: Health News from Medical News Today)

Enlarged Blind Spot After Cataract SurgeryEnlarged Blind Spot After Cataract Surgery

Medscape Today Headlines — Tue, 20 Dec 2011 18:11:58 +0100

A 60-year-old man reports a large blind spot in his left eye after a cataract extraction and lens implant. What is your diagnosis? Medscape Ophthalmology (Source: Medscape Today Headlines)

FDA collaboration to monitor rare eye condition associated with cataract surgery

Food and Drug Administration — Tue, 20 Dec 2011 15:18:00 +0100

The U.S. Food and Drug Administration and other government and professional organizations today unveiled a program to monitor medical devices used in cataract surgery in an effort to stem outbreaks of a rare, inflammatory condition associated with the procedure. (Source: Food and Drug Administration)

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Similarity metrics for surgical process models

Artificial Intelligence in Medicine — Sat, 17 Dec 2011 15:37:48 +0100

The objective of this work is to introduce a set of similarity metrics for comparing surgical process models (SPMs). SPMs are progression models of surgical interventions that support quantitative analyses of surgical activities, supporting systems engineering or process optimization.Methods and materials: Five different similarity metrics are presented and proven. These metrics deal with several dimensions of process compliance in surgery, including granularity, content, time, order, and frequency of surgical activities. The metrics were experimentally validated using 20 clinical data sets each for cataract interventions, craniotomy interventions, and supratentorial tumor resections. The clinical data sets were controllably modified in simulations, which were iterated ten times, resulting...

Traumatic expulsive iridodialysis with vitreous prolapse

International Ophthalmology — Thu, 15 Dec 2011 16:50:46 +0100

We report a case of dehiscence of the cataract wound and traumatic expulsive iridodialysis that also exhibited vitreous prolapse. Content Type Journal ArticleCategory Photo EssayPages 1-2DOI 10.1007/s10792-011-9491-3Authors Ane Zurutuza, Department of Ophthalmology, Complejo Hospitalario de Navarra, 31008 Pamplona, SpainJose Andonegui, Department of Ophthalmology, Complejo Hospitalario de Navarra, 31008 Pamplona, SpainLara Berástegui, Department of Ophthalmology, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain Journal International OphthalmologyOnline ISSN 1573-2630Print ISSN 0165-5701 (Source: International Ophthalmology)

Monocyte chemoattractant protein‐1 in the aqueous humor of patients with age‐related macular degeneration

Clinical and Experimental Ophthalmology — Thu, 15 Dec 2011 05:00:00 +0100

Conclusion: Elevated levels of inflammation‐related cytokines in the aqueous humor in various stages of AMD may suggest a pathogenic role of inflammation. MCP‐1 may be indicative of the angiogenic phase. Further corroborative studies are required. (Source: Clinical and Experimental Ophthalmology)

Cataract Surgery: Use Grade 2 Reading Level in Consent FormsCataract Surgery: Use Grade 2 Reading Level in Consent Forms

Medscape Today Headlines — Wed, 14 Dec 2011 19:50:36 +0100

Even well-educated patients do better with simpler informed-consent practices. Medscape Medical News (Source: Medscape Today Headlines)

JCRS 2011: Looking back, looking ahead

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

As 2012 begins, we reflect on a year of progress at the Journal of Cataract & Refractive Surgery and look ahead with excitement to the coming year. Every issue of JCRS is a product of innumerable hours of effort, and we wish to take this opportunity to thank all those who make JCRS the leading peer-reviewed anterior segment surgery journal. Each of us is a reader, and among these readers we also find authors, reviewers, editorial board members, office staff, advertisers, and publishers. Every person who touches the journal in one or another way has contributed something to its success, and to the efforts of each of these people, the journal is indebted. (Source: Journal of Cataract and Refractive Surgery)

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Single versus double femtosecond laser pass for incomplete laser in situ keratomileusis flap in contralateral eyes: Visual and optical outcomes

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Conclusions: Visual acuity, refractive outcomes, and anterior corneal HOAs were comparable between eyes after uneventful femtosecond laser single pass or double pass after suction loss affecting the pupillary area. A new femtosecond laser pass performed immediately after incomplete flap due to intraoperative suction loss provided good visual and optical outcomes.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Optical quality after myopic photorefractive keratectomy and laser in situ keratomileusis: Comparison using a double-pass system

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Conclusions: Retinal image quality was similarly reduced with PRK and LASIK, with no significant differences between the 2 methods. Some PRK patients had a residual refractive error that might have been related to corneal-wound healing still present 3 months postoperatively.Financial Disclosure: Dr. Arjona is an investor in and Drs. Güell and Pujol are investors in and consultants to Visiometrics S.L., Terrassa, Spain. None of the other authors has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

Central vault after phakic intraocular lens implantation: Correlation with anterior chamber depth, white-to-white distance, spherical equivalent, and patient age

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Purpose: To compare the central postoperative vault of a phakic intraocular lens (pIOL) to correct myopia, myopic astigmatism, and hyperopia and identify ocular and lens parameters that might predict the vault amount.Setting: Fernández-Vega Ophthalmological Institute, Oviedo, Spain.Design: Cohort study.Methods: Three months after implantation of Implantable Collamer Lens pIOLs to correct myopia, hyperopia, and myopic astigmatism, central vault was measured using optical coherence tomography. Patients were divided into groups according to the preoperative anterior chamber depth (ACD) to compare the effects of ACD, white-to-white (WTW) distance, and lens diameter on postoperative pIOL vault.Results: Hyperopic pIOLs had statistically significantly lower vault followed by myopic pIOLs and tor...

Refractive shift in pseudophakic eyes during the second decade of life

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Purpose: To evaluate the refractive shift in pseudophakic eyes of children after their 10th birthday.Setting: Storm Eye Institute, Charleston, South Carolina, USA.Design: Case series.Methods: One eye of each patient with at least 2 refractions at a minimum of a 1-year interval after the 10th birthday was analyzed.Results: One hundred fourteen pseudophakic eyes (114 patients) were identified. The mean initial refraction was −0.65 diopter (D) ± 2.27 (SD) and the mean final refraction, −1.78 ± 2.82 D. The mean shift in refraction was −1.13 ± 1.36 D; the mean shift in refraction per year was −0.30 ± 0.38 D. Postoperative refraction could be predicted by regression analysis (P (Source: Journal of Cataract and Refractive Surgery)

Homeostatic response of intraocular pressure in the early period after sutureless phacoemulsification

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Purpose: To determine the homeostatic response of postoperative intraocular pressure (IOP) by analyzing postoperative IOP trends after sutureless phacoemulsification.Setting: Asan Medical Center, Seoul, South Korea.Design: Comparative case series.Methods: Normotensive eyes were treated with sutureless phacoemulsification with in-the-bag posterior chamber IOL (PC IOL) implantation. The patients were randomly divided into 3 groups according to the intended immediate postoperative IOP as follows: Group 1, IOP less than 10 mm Hg; Group 2, IOP 10 to 21 mm Hg; Group 3, IOP over 21 mm Hg. The surgeon intentionally attempted supranormal, normal, or subnormal pressurization. The IOP was measured immediately after surgery and 2 hours, 4 hours, 1 day, 1 week, and 1 month postoperatively.Results: Grou...

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Lenticular meridional astigmatism secondary to iris mesectodermal leiomyoma

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

A 61-year-old African American man presented with decreased vision of 2 months duration. Examination revealed a significant lenticular astigmatism and sectoral cataract as a result of an amelanotic iris lesion. Slitlamp optical coherence tomography (OCT) revealed angle crowding. An excisional biopsy was performed along with phacoemulsification in the right eye, with intraocular lens implantation for meridional lenticular astigmatism. Histopathology and histoimmunochemistry confirmed a diagnosis of uveal mesectodermal leiomyoma. Lenticular astigmatism may be a subtle sign of an anterior segment tumor. Anterior segment slitlamp OCT is an effective tool in diagnosing as well as monitoring small interval changes in these types of tumors.Financial Disclosure: No author has a financial or propri...

Brown discoloration of acrylic multifocal, monofocal, and blue light–filtering IOLs

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

It has been 20 years since I first detected and reported browning or discoloration of silicone intraocular lenses (IOLs) made by Staar, Iolab, and Allergan. It is ironic that I have detected and now report browning in an acrylic multifocal IOL (Restor) and monofocal IOL (Acrysof) (both Alcon Laboratories, Inc.) and an aspheric blue light–filtering IOL (PY-60AD, Hoya Surgical Optics GmbH). These are the first observed and reported cases of these IOLs that have become discolored brown after implantation. There were reports of discolored IOLs in 2007 and 2008. These IOLs were stained blue; 1 from inadvertent use of methylene blue instead of trypan blue and 1 from the systemic use of a drug to treat urinary tract infection (Prosed DS) that contains methylene blue. Both IOLs were made of si...

Refractive Surgical Problem: January consultation #1

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

A 51-year-old man who had previous penetrating corneal transplantation (penetrating keratoplasty [PKP]) for keratoconus in the right eye presented to his primary ophthalmologist 2 years later with a visually significant cataract. Because of high and relatively symmetric astigmatism, the patient had phacoemulsification with implantation of an Acrysof IQ toric intraocular lens (IOL) (SN60T7, Alcon Laboratories, Inc.) to correct post-PKP astigmatism. (Source: Journal of Cataract and Refractive Surgery)

January consultation #2

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

This case highlights the potential problems associated with the use of advanced IOLs (toric and multifocal) concomitant with or after full-thickness corneal transplantation. In general, I avoid these IOLs because the corneal transplant has a finite survival and if a repeat transplant is required (as in this case), you are left with a refractive dilemma. When possible, I prefer post-PKP corneal refractive surgery to deal with residual refractive errors. The exceptions could be a very elderly recipient, where the risk for rejection is lower and the expected graft survival may exceed the life expectancy of the patient, or (as in this case) patients with keratoconus, where overall graft survival is quite high. This case also highlights the risk that any surgical intervention or manipulation co...

January consultation #3

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Options for management of corneal endothelial failure after PKP include repeat PKP, endothelial keratoplasty, and keratoprosthesis implantation. The decision on the most appropriate treatment modality depends on several factors, including historical factors (eg, number of previous graft failures, spectacle-corrected or contact lens–corrected vision before graft failure, patient's ability to successfully wear a contact lens before graft failure), anatomic factors (eg, significant corneal stromal opacification, presence of an intracapsular toric IOL), and other factors that would complicate the performance of DSEK (eg, peripheral anterior synechiae, anteriorly positioned tube shunts, presence of an anterior chamber IOL, aphakia, partial or complete aniridia). (Source: Journal of Cataract a...

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January consultation #4

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Treatment of post-PKP corneal astigmatism has always been a challenge to ophthalmic surgeons. The introduction of refractive procedures, such as laser in situ keratomileusis (LASIK), femtosecond-assisted arcuate keratotomies, and toric IOL implantation, has offered effective approaches to manage this problem. (Source: Journal of Cataract and Refractive Surgery)

January consultation #5

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

The key issue in this case is astigmatic management. The implantation of the high-power toric IOL makes the eye have an inherent 3.00 diopters (D) of cylinder at the corneal plane. There are 3 possible approaches to rehabilitate the patient's vision. The first is a traditional PKP. The combination of the astigmatism from the repeat corneal transplantation and from the toric IOL will lead to challenging postoperative astigmatic correction. The curvature of the corneal plane would have to be adjusted to offset the astigmatism induced by the toric IOL. This is achievable as long as the axis of the toric IOL is known. (Source: Journal of Cataract and Refractive Surgery)

January consultation #6

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

In this case, several questions come to mind. First is whether continued medical treatment and a therapeutic contact lens (TCL) would resolve the visual problems or whether surgical treatment is needed. The corneal edema and irregular epithelium indicate corneal decompensation. Although medical treatment and TCL wear can alleviate the pain, they may have no effect on visual rehabilitation. I believe the patient should be treated surgically. (Source: Journal of Cataract and Refractive Surgery)

January consultation #7

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

The overall picture suggests that the visual loss is caused by graft edema secondary to endothelial failure. Although the irregular astigmatism on topography is a concern, the patient achieved 20/25 CDVA after cataract surgery. Thus, the astigmatism is probably the result of epithelial irregularity secondary to edema. In-office epithelial debridement followed by topography of the deepithelialized cornea could differentiate epithelial irregularity from true corneal irregularity. Because the patient was satisfied after cataract surgery (before graft failure), he could have DSAEK. I make my main incision in the steep meridian and expect an approximate 1.00 D hyperopic shift postoperatively. (Source: Journal of Cataract and Refractive Surgery)

January consultation #8

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Some surgical options to treat graft failure can yield good visual outcomes. Repeat PKP and endothelial keratoplasty, in particular DSAEK, are alternatives. A serious drawback of repeat PKP is the slow visual recovery resulting from large and unpredictable refractive changes; the implanted toric IOL should also be taken into consideration because refractive changes after PKP regraft are inevitable. The repeat PKP and IOL exchange can be performed at the same time or as a 2-stage procedure consisting of repeat PKP followed months later by IOL exchange. The first alternative avoids an additional surgery and allows rapid recovery of vision; however, it may result in large refractive errors because of the inability to predict the IOL power correctly. The risks of this procedure include poster...

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January consultation #9

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

With the toric IOL in place, a PKP regraft would lead to induced astigmatism even if the transplant were perfectly spherical. If the regraft were not spherical, it would lead to complex astigmatism in combination with the IOL. Therefore, placement of an endothelial keratoplasty under the failed PKP is a better choice if the patient had acceptable visual and refractive results before PKP failure, which this patient did. This case is a great example of why toric IOLs should be implanted after PKP only when the PKP failure can be treated with endothelial keratoplasty. (Source: Journal of Cataract and Refractive Surgery)

Risk stratification and assessment in cataract surgery

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

I believe the classification system for preoperative risk stratification for cataract surgery proposed by Gupta et al. is flawed in that no account of cumulative risk is made. Narendran et al. highlight the odds ratio (OR) and cumulative probability of vitreous loss with each risk factor and demonstrate that there is increasing risk with each additional risk factor present. Although the simple system proposed by Gupta et al. is appealing, it takes no account of this, which may falsely reassure. (Source: Journal of Cataract and Refractive Surgery)

Reply

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

The cataract classification we described is a simple guide to surgical complexity rather than an attempt to quantify a risk for a specific complication, ie, posterior capsule rupture. Although this complication may be a surrogate of surgical complexity, it was our aim to tailor the 3-point CC grade to a specific training task(s). To use the example Dr. Butler describes, a 70-year-old patient with pseudoexfoliation may require iris hooks and a capsular tension ring, which demands specific surgical skills and familiarity with these devices. In contrast, a 90-year-old patient with glaucoma, controlled intraocular pressure, and background diabetic retinopathy may not require any additional surgical skills compared with a younger patient without these comorbidities. In the event of a posterio...

Oval capsulorhexis and its advantages

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Singh et al.’s recent article on oval capsulorhexis for posterior polar cataract associated with preexisting capsule defect highlights important points in the surgical management, as well as providing some very educational videos. Surprisingly, the authors used sulcus-fixated intraocular lenses (IOLs) in only 2 cases. They preferred the endocapsular implantation in most cases, even without converting the defect into a posterior circular continuous capsulorhexis (PCCC). Any type of IOL can be placed inside the capsular bag if a posterior capsule rupture can be converted successfully into a PCCC. A sulcus-fixated IOL represents the safest option for unstable posterior capsule rupture. In addition, a 3-piece IOL can be placed in the bag when the optic can be securely captured through the ...

Reply

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Dr. Carifi pointed out 3 main issues with the oval capsulorhexis. First, the IOL should be placed in the capsular bag only after converting the posterior capsule rupture into a PCCC. Second, the sulcus-fixated IOL whose optics were captured with oval capsulorhexis could lead to IOL instability. Third, the diaphragm between anterior and posterior segments created by an oval capsulorhexis is weaker than that created by a small capsulorhexis. Our opinion on these issues is as follows: (Source: Journal of Cataract and Refractive Surgery)

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Steroid depot injection versus postoperative steroid eyedrops to prevent inflammation and macular edema after cataract surgery

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

In the recent article by Dieleman et al., the methods and discussion were not adequate. First, measuring foveal thickness at 4 weeks is too early to detect all cases of macular edema, which peaks at 4 to 6 weeks and may develop several months after the surgery, as discussed in the article. Moreover, only 1% of macular edema cases show a significant decrease in vision and subsequent improvement can occur in 3 to 12 months in 80%. Hence, all patients might not have come for extra clinic visits, making the follow-up inadequate and not representative. (Source: Journal of Cataract and Refractive Surgery)

Reply

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

We appreciate the interest and comments of Dr. Kamal. To respond to the first comment, we agree that measurement of foveal thickness after 4 weeks is too early to detect all cases of macular edema. In our study, the postoperative follow-up visits were scheduled in accordance with our standard postoperative evaluations; therefore, the measurements were taken 4 weeks after cataract extraction. We tried to account for this by reviewing patients’ records after 6 months to determine the number of visits for post-cataract clinical macular edema after the last study visit. We agree with Dr. Kamal that we certainly could have missed some cases, but this applies to both groups. If we had measured 6 weeks after cataract extraction or at another fixed time point, we also could have missed some case...

Prevention of post cataract–surgery cystoid macular edema with nepafenac

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

The recent article by Miyake et al. on post cataract–surgery cystoid macular edema left me with questions about study design and financial disclosures. The results are not surprising given that fluorometholone 0.1% is known to have poor corneal penetration and would not be expected to have significant effects on the posterior segment. Why not compare nepafenac with a steroid with better penetration, one that is more commonly used as part of the post cataract–surgery regimen (eg, prednisolone acetate 1.0%), another nonsteroidal agent with proven penetration and efficacy in treatment or prevention of postoperative cystoid macular edema, or an inert control? (Source: Journal of Cataract and Refractive Surgery)

Reply

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

We agree with Dr. Glasser that the intraocular penetration of topical fluorometholone is lower than that of other steroids. We performed a similar study in which we compared the effects of diclofenac and fluorometholone in preventing postoperative breakdown of the blood–aqueous barrier and cystoid macular edema. We also compared the above-mentioned effects of diclofenac and betamethasone. We observed that diclofenac was more effective than the steroid and that betamethasone induced elevation in intraocular pressure in postoperative pseudophakic eyes. We based the design of the present study on these findings. The most essential reason for selecting fluorometholone as the control drug was its similarity in appearance to nepafenac; this enabled us to perform a double-masked scientific comp...

Assessing the value of simulator training on residency performance

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

Many residency programs, including ours at the University of California San Francisco, have acquired surgical simulator technology without persuasive peer-reviewed evidence to quantify its value in improving resident education and outcomes. Studies such as the one by Belyea et al. attempting to document the value of simulator training are important because of the significant cost of the technology relative to the budgets of most residency programs. However, we are concerned that the study design and results do not adequately support the conclusions. (Source: Journal of Cataract and Refractive Surgery)

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Reply

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

We thank Drs. Naseri and Chang for their comments on our article and their contribution to the discussion of the role of surgical simulators in ophthalmology resident training. Our study investigated the effect of simulator training on intraoperative surgical performance, and its primary findings were statistically significant improvements in phacoemulsification time, phacoemulsification power, and adjusted phacoemulsification time. (Source: Journal of Cataract and Refractive Surgery)

Editorial Board

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

(Source: Journal of Cataract and Refractive Surgery)

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

(Source: Journal of Cataract and Refractive Surgery)

Masthead

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

(Source: Journal of Cataract and Refractive Surgery)

Visual Acuity Chart

Journal of Cataract and Refractive Surgery — Tue, 13 Dec 2011 17:01:47 +0100

(Source: Journal of Cataract and Refractive Surgery)

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Endophthalmitis following cataract surgery: the role of prophylactic postoperative chloramphenicol eye drops

Acta Ophthalmologica — Tue, 13 Dec 2011 05:00:00 +0100

Conclusion: We found no difference in the frequency of PE following cataract surgery when changing the postoperative topical medication from a mixture of corticosteroids and antibiotics to only corticosteroids. (Source: Acta Ophthalmologica)

Fifty Years of Ophthalmic Laser Therapy [Editorial]

Archives of Opthalmology — Mon, 12 Dec 2011 05:00:00 +0100

(Source: Archives of Opthalmology)

The economic cost of posterior capsule tear at cataract surgery

British Journal of Ophthalmology — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions Based on the National Health Service national tariff, a PCT during cataract surgery results in significant additional financial cost to healthcare purchasers. A full cost analysis would be required to estimate the additional cost of a PCT for the healthcare provider. (Source: British Journal of Ophthalmology)

Cataract surgery in eyes with congenital iridolenticular choroidal coloboma

British Journal of Ophthalmology — Mon, 12 Dec 2011 05:00:00 +0100

Cataract surgery in eyes with coloboma can present intraoperative challenges and pose greater risk of complications because of the associated ocular malformations.1 2 There may be associated scleral weakness in the fetal cleft region, zonular deficiency, poor pupillary dilatation and accompanied microphthalmos. In addition, these eyes are to be handled with great caution due to the increased risk of retinal detachment, association of maculopathy and poor surgical results. There are very few reports on the outcomes of cataract surgery in eyes with congenital coloboma owing to its relatively infrequent occurrence. The aim of this study is to describe our experience of cataract surgery in 26 eyes of 25 patients with congenital iridolenticular choroidal coloboma. Methods From January 2009 to D...

Glaucoma a risk with modern infant aphakia surgery

Modern Medicine — Fri, 09 Dec 2011 05:00:00 +0100

NEW YORK (Reuters Health) - Modern surgical techniques don't completely eliminate the risk of glaucoma in children who have cataract surgery, a new report says. (Source: Modern Medicine)

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A Comparison of Preservative-Free Diclofenac and Preserved Diclofenac Eye Drops after Cataract Surgery in Patients with Diabetic Retinopathy

Journal of Ocular Pharmacology and Therapeutics — Wed, 07 Dec 2011 16:28:47 +0100

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

Cataract Surgery Complications: An In Vitro Model of Toxic Effects of Ropivacaine and Lidocaine

Drugs in R — Wed, 07 Dec 2011 07:01:54 +0100

This article is currently available as a free download on ingentaconnect (Source: Drugs in R)

The discriminative power of patient experience surveys

BMC Health Services Research — Tue, 06 Dec 2011 05:00:00 +0100

Conclusions From a statistical point of view, the discriminative power appears limited. The sample sizes required for reliable estimates are often substantial and deserve careful consideration when setting up measurements. Future research should evaluate the discriminative power by validating differences between providers in patient experiences with other indices and should explore other, more sensitive measures of patient experiences regarding treatment-related changes in physical functioning. (Source: BMC Health Services Research)

Long-term follow-up of changes in corneal endothelium after primary and secondary intraocular lens implantations in children

Graefe's Archive for Clinical and Experimental Ophthalmology — Mon, 05 Dec 2011 17:40:11 +0100

Conclusions Our results did not show any significant corneal endothelial cell loss in congenital cataract patients; however, their CCTs were increased. Content Type Journal ArticleCategory PediatricsPages 1-6DOI 10.1007/s00417-011-1872-9Authors Mi Jeung Kim, Department of Ophthalmology, Seoul National University College of Medicine, 28 Yeongun-Dong,Chongro-Ku, Seoul, 110-744 KoreaJeong Hun Kim, Department of Ophthalmology, Seoul National University College of Medicine, 28 Yeongun-Dong,Chongro-Ku, Seoul, 110-744 KoreaSeong-Joon Kim, Department of Ophthalmology, Seoul National University College of Medicine, 28 Yeongun-Dong,Chongro-Ku, Seoul, 110-744 KoreaYoung Suk Yu, Department of Ophthalmology, Seoul National University College of Medicine, 28 Yeongun-Dong,Chongro-K...

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Cytoskeletal drugs prevent posterior capsular opacification in human lens capsule in vitro

Graefe's Archive for Clinical and Experimental Ophthalmology — Fri, 02 Dec 2011 17:27:43 +0100

Conclusion H-7 and LAT-B dose-dependently inhibited PCO formation in the cultured human lens capsular bags, suggesting that cytoskeletal drugs might prevent PCO formation after surgery in the human eye. Content Type Journal ArticleCategory Basic SciencePages 1-8DOI 10.1007/s00417-011-1869-4Authors Jeyalakshmi Sureshkumar, Aravind Medical Research Foundation, Dr. G. Venkataswamy Eye Research Institute, No.1, Anna Nagar, Madurai, 625020 Tamil Nadu, IndiaAravind Haripriya, Cataract Clinic, Aravind Eye Hospital, Madurai, IndiaVeerappan Muthukkaruppan, Aravind Medical Research Foundation, Dr. G. Venkataswamy Eye Research Institute, No.1, Anna Nagar, Madurai, 625020 Tamil Nadu, IndiaPaul L. Kaufman, Ophthalmology & Visual Sciences, University of Wisconsin, Madison, WI, USA...

[Early in-the-bag spontaneous intraocular lens dislocation of hydrophilic acryl single piece lenses following uncomplicated phacoemulsification.]

Der Ophthalmologe — Fri, 02 Dec 2011 05:00:00 +0100

CONCLUSIONS: Careful selection of suitable lens design and material according to individual predisposing factors is necessary. This retrospective case study demonstrates that the combination of hydrophilic lens material and a thin lens design may result in early spontaneous IOL dislocation. Furthermore, as established in one case, YAG laser capsulotomy may induce IOL dislocation if the lens design cannot withstand capsular fibrosis. PMID: 22130724 [PubMed - as supplied by publisher] (Source: Der Ophthalmologe)

Cataract and Juvenile Arthritis

Ophthalmology — Thu, 01 Dec 2011 05:00:00 +0100

This study looked at all children with juvenile arthritis associated uveitis who were seen in the Ocular Immunology Clinic at the Wilmer Eye Institute between July 1984 and August 2005. The study group included 75 children in total, and found that 22.5% of eyes had cataract and an additional 23.1% of eyes had already undergone cataract surgery by the time of presentation. Therefore, almost half of all the eyes (45.6%) had experienced cataract. (Source: Ophthalmology)

Author reply

Ophthalmology — Thu, 01 Dec 2011 05:00:00 +0100

Thank you for your response to our manuscript evaluating the effects of treatment (specifically topical corticosteroids) on the development of cataract in patients with chronic uveitis associated with juvenile idiopathic arthritis (JIA). Although the authors are correct that 45% of eyes with JIA uveitis had had either cataract or cataract surgery, this is the frequency of occurrence at the time in which patients presented to our clinic rather than the cataracts that were diagnosed while patients were under observation for the study. During the observed follow up, 9 of 60 eyes with chronic uveitis and at risk for developing cataract, developed cataract for an incidence rate of 0.04 per eye-year (/EY; 95% confidence interval = 0.02/EY to 0.09/EY) over a mean follow up of 4.6 years. Sabri et ...

[Vision with bifocal and multifocal intraocular lenses].

Der Ophthalmologe — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Kirschfeld K, Land MF Abstract Bifocal or multifocal intraocular lenses (IOLs) can be used to replace natural lenses during cataract surgery. These lenses are recommended by cataract surgeons as the replacement lenses of choice when patients wish to avoid wearing spectacles. There are, however, drawbacks to these lenses: one drawback is that the contrast in the images of bifocal and multifocal lenses is reduced as documented in the ophthalmology literature. It is claimed that acuity is similar in multifocal compared to monofocal lenses, however, we show that any loss in contrast inevitably reduces visual acuity. The other drawback is that the sharp in-focus image is always seen superimposed on one or more blurred out of focus images of the same object. In the ophthalmology...

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The impact of gender on first eye cataract surgery and motor vehicle crash risk for older drivers

Clinical and Experimental Ophthalmology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: The results of this study suggest that clinicians may need to take gender into account when advising patients on driving safety before and after cataract surgery. (Source: Clinical and Experimental Ophthalmology)

Endothelial Cell Decay after Descemet's Stripping Automated Endothelial Keratoplasty and Top Hat Penetrating Keratoplasty [Cornea]

Investigative Ophthalmology — Tue, 29 Nov 2011 05:00:00 +0100

Conclusions. After DSAEK, early ECD decay was stronger than after THPK, as opposed to late decay. Late decay was faster for PPBK than for FED after DSAEK. (Source: Investigative Ophthalmology)

Conditional ablation of the Notch2 receptor in the ocular lens.

Developmental Biology — Tue, 29 Nov 2011 05:00:00 +0100

Authors: Saravanamuthu SS, Le TT, Gao CY, Cojocaru RI, Pandiyan P, Liu C, Zhang J, Zelenka PS, Brown NL Abstract Notch signaling is essential for proper lens development, however the specific requirements of individual Notch receptors have not been investigated. Here we report the lens phenotypes of Notch2 conditionally mutant mice, which exhibited severe microphthalmia, reduced pupillary openings, disrupted fiber cell morphology, eventual loss of the anterior epithelium, fiber cell dysgenesis, denucleation defects, and cataracts. Notch2 mutants also had persistent lens stalks as early as E11.5, and aberrant DNA synthesis in the fiber cell compartment by E14.5. Gene expression analyses showed that upon loss of Notch2, there were elevated levels of the cell cycle regulators Cdkn1a (...

Human anterior lens capsule epithelial cells contraction

Acta Ophthalmologica — Sun, 27 Nov 2011 02:55:05 +0100

Conclusions: This study provides the evidence that contractions of the anterior lens epithelial cells take place in significant portion of human lens anterior capsule postoperative preparations after non‐specific stimulation. Contractions are at least partially independent of changes in [Ca2+]i. They can be mechanically induced, are localized and reversible and have a fast response and did not differ among different types of cataract. Physiological and clinical significance of this phenomenon remains to be elucidated. (Source: Acta Ophthalmologica)

Impact on visual function from light scattering and glistenings in intraocular lenses, a long‐term study

Acta Ophthalmologica — Sun, 27 Nov 2011 02:54:40 +0100

Conclusion: Most patients in this case series operated 10 years previously had severe glistenings and a high level of light scattering from their intraocular lenses. No detectable impact on BCVA, LCVA 10% and 2.5% was found. (Source: Acta Ophthalmologica)

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The outcome of cataract surgery measured with the Catquest‐9SF

Acta Ophthalmologica — Sun, 27 Nov 2011 02:54:38 +0100

Conclusion: The Catquest‐9SF shows excellent psychometric properties, as demonstrated by Rasch analysis. It is highly responsive to cataract surgery, and its brevity (nine items) makes it well suited for use in daily clinical practice. (Source: Acta Ophthalmologica)

Effectiveness of the use of intracameral cefuroxime as prophylaxis in cataract surgery.

Farmacia Hospitalaria — Wed, 23 Nov 2011 05:00:00 +0100

Authors: Fontanet JM, March F, Morón A, Gorgas MQ PMID: 22118765 [PubMed - as supplied by publisher] (Source: Farmacia Hospitalaria)

Perioperative steroids and cataract surgery

Optometry - Journal of the American Optometric Association — Tue, 22 Nov 2011 16:29:29 +0100

Even with the latest innovation in surgical techniques and equipment, inflammation is induced by the cataract surgical procedure. Resultant inflammation may be observed as corneal edema, anterior chamber cell and flare, as well as cystoid macular edema (CME). The authors compare the effects of 2 corticosteroids on corneal thickness and visual acuity (VA) following cataract surgery. (Source: Optometry - Journal of the American Optometric Association)

Light-adjustable intraocular lens technology