The Athens Protocol: Topography-
Guided Partial PRK With CXL
emAn effective way to stabilize and visually
rehabilitate patients with keratoconus
and post-LASIK ectasia./em
strongBy A. John Kanellopoulos, MD/strong/p…
Month: April 2013
Keratitis After a Limbal Relaxing Incision
As cataract surgery becomes more technologically
advanced and patients’ expectations soar, it is
more important than ever for surgeons to achieve
the target refraction—usually emmetropia.
Because one of the biggest causes of patients’ di…
Corneal Collagen Cross-Linking in Children
Keratoconus is a slowly progressive, noninflammatory
corneal thinning disorder characterized
by changes in the structure and organization of
corneal collagen. The ectasia progresses at a variable
rate and may be more rapid in pediatric patient…
Traumatic Cataract
This case contains several challenges that surgeons
often see independently but sometimes
encounter in combination. After trauma, this
eye had an atonic, enlarged, fibrotic pupil; at
least 6 clock hours of zonular loss; vitreous prolapsed
int…
Concentric Intrastroma Boxed Suturing Technique
Corneal wound burns induced
by phacoemulsification present
a difficult problem. Due to the
thermal shrinkage of nearby
tissue, some superficial corneal tissue is
missing across the wound, and hence,
traditional sutures do not work. Even
if …
Pseudoexfoliation: Small Pupil, Loose Zonules
Approximately 20% of my cataract patients
have pseudoexfoliation (PXF) and often
present with poor pupillary dilation and/or
zonular instability. Many of them go through
surgery without complication, but severely affected
patients present a p…
Is Spectacle Independence Achievable?
emA patient in his mid-50s presents with a unilateral cataract and a refraction of -5.00 +1.00 × 180. The fellow
eye is pseudophakic with a refraction of -3.00 +4.00 × 180. The patient tells you that his previous surgeon, who
has retired, to…
You Say Goodbye, and I Say Hello
My 6 years as chief medical editor of emCataract and Refractive Surgery Today/em end with this editorial.
I remember when David Cox and Adam
Krafczek, cofounders of emCRST/em, offered the role
to me. They have always joked that I did not…
Measure Twice, Cut Once
In refractive cataract surgery, when a central goal of
the procedure is good UCVA, there is little room for
error in the IOL power calculation. Current-generation
biometers and modern formulas have reduced inaccuracy,
and they have made it pos…
Zonular Dehiscence
Significant zonular dehiscence or weakness poses a
challenge during cataract surgery. The ophthalmologist
may not detect instability of a dense cataract
until the initial steps of cataract surgery, particularly
creation of the capsulorhexis, w…
Visually Significant Traumatic Cataract
PRIYA NARANG, MS, AND
AMAR AGARWAL, MS, FRCS, FRCOphth
Figure 1 shows traumatic subluxation of the lens with
7 clock hours of zonular loss. The clinical picture is suggestive
of phacodonesis, and small wisps of vitreous are
present…
Point/Counterpoint: Epithelium on Versus Epithelium off
The Case for
Epithelium-on CXL
emStandardization will help overcome objections
to transepithelial CXL./em
strongBy Parag A. Majmudar, MD/strong
Corneal collagen cross-linking (CXL; not
approved for use in t…
Posterior Corneal Astigmatism and Toric IOLs
How do you factor in posterior corneal
astigmatism when selecting the
power of a toric IOL if the patient has
anterior corneal with-the-rule astigmatism
or anterior corneal against-the-
rule astigmatism? How do you
optimize the end result fo…
A Dense Brunescent Cataract With a Thick Fibrotic Membrane
An 88-year-old man presented for a routine
examination. He was an extremely poor historian
and lived in a remote area of Florida.
When his daughter visited, she noticed he was
having trouble seeing and functioning. The examination
revealed an…
Posterior Capsular Rupture
This article details a case of posterior capsular rent
managed with a vitrectomy and reverse optic capture of
a toric IOL.
BACKGROUND
A 67-year-old woman with a prior history of laser
peripheral iridotomies was referred for …
OIG’s strong language on physician-owned distributorships is clear message to investors
In a Special Fraud Alert released on March 26, the Department of Health and Human Services Office of Inspector General (OIG) stated in no uncertain terms that physician-owned entities that arrange for the sale of “implantable medical devices ordered by their physician-owners for use in procedures [that] the physician-owners perform on their own patients at hospitals or ambulatory surgical centers” are “inherently suspect under the anti-kickback statute.” According to the OIG alert, these PODs “produce substantial fraud and abuse risk and pose dangers to patient safety.” As such, a POD (Read more...)
DSEK vs PKP: Which Is Best, and Why?
In regard to graft failure and cell loss, which corneal transplant technique is superior? Medscape Ophthalmology
SD-OCT appropriate in evaluating foveal sparing in geographic atrophy
Spectral domain optical coherence tomography, followed by blue light fundus autofluorescence and near-infrared fundus autofluorescence, is appropriate to evaluate foveal sparing in patients with geographic atrophy, according to a study.The study includ…
Pallimed recalls all sterile compound products
Pallimed Solutions, doing business as Pallimed Pharmacy, has recalled all sterile compound products dispensed since Jan. 1, 2013, due to the presence of visible particulates in several vials of different products, according to press releases from the c…
Patient age correlates with postoperative refractive outcomes in highly myopic eyes
Patient age affects postoperative refractive outcomes in LASIK correction of myopia, according to a retrospective case series.At 1 year after surgery, 612 eyes that had preoperative myopia higher than 5 D were analyzed.