I obtained a YAG laser very early. I visited my friend Danièle Aron-Rosa, MD, in Paris after her first reports, and she allowed me to perform YAG laser capsulotomy on three of her patients. I was amazed. I had been doing phacoemulsification with posterior chamber lens implantation since 1977. I performed posterior capsulotomy with a needle knife under a Zeiss Opmi 1 operating microscope through the pars plana in my office surgery suite. It was a disruptive innovation to be able to perform a posterior capsulotomy with a painless laser (Read more...)
Author: Healio ophthalmology
The dry eye doc with dry eye
So many of us went to medical school with a very clear idea of what kind of doctor we would be when we “grew up.” Often times that decision was based on a very influential doctor we might have known as a child. Sometimes we chose our specialty because of medical experiences we, or someone in our family, may have had. Pretty much all of us have heard the joke about classmates going into psychiatry to figure out why they were crazy. In my case, my body was so beaten (Read more...)
Genetic therapies offer new pathways for ophthalmic disorders
Genetic therapies for ophthalmic disorders such as inherited retinal dystrophies are moving forward in the field and taking steps toward becoming a clinical reality.
The future of gene therapy in retinal disease is a bright one, with many gene therapy companies offering exciting possibilities, Jay S. Duker, MD, a co-founder of Hemera Biosciences, a privately held biotech company, told Ocular Surgery News.
“Gene therapy is being tested in many organ systems, but the retina is one of the best organs in the body to consider gene therapy for several reasons. (Read more...)
Elderly woman presents with rapidly progressive bilateral ophthalmoplegia and blindness
An 80-year-old woman was transferred from an outside hospital to the emergency department at Tufts Medical Center for ophthalmological evaluation around midnight. In a matter of hours, she had developed bilateral, progressive ophthalmoplegia and complete vision loss. She endorsed worsening “swelling” of the left upper eyelid and numbness around the left eye and cheek for the past 2 days. She also reported a 1-week history of pain in the left forehead and temple, as though her jaw felt “locked.” Her primary care physician had recently discovered ethmoidal and sphenoidal
Technological advances improve safety, precision of YAG vitreolysis for floaters
An upgrade in YAG laser technology may be a breakthrough in the management of vitreous floaters, offering a safe, effective and minimally invasive alternative that lies between “learn to live with it” and vitrectomy.
YAG laser vitreolysis has been around for some time, and a handful of surgeons worldwide embraced it long ago, have seen its potential and worked at further developments. The technique, however, has been surrounded by controversy due to justified safety concerns and lack of data. Difficulty in exactly targeting floaters, the risk of damaging the retina (Read more...)
IOL calculations in eyes with prior hyperopic LASIK
We know that patients who underwent prior corneal refractive surgery pose more of a challenge when it comes to performing IOL calculations for cataract surgery. The reason is that the anterior surface of the cornea has been steepened while the posterio…
Are there alternatives for treating floaters?
Click here to view the Cover Story to this Point/Counter.The problem with floaters is the shadow they cast on the retina when light is projected on them. Size and location play a role: The bigger the floater and the nearer to the retina, the more inten…
Anterior chamber vs. posterior chamber IOLs: What works best in eyes with no capsular support?
Welcome to another edition of CEDARS/ASPENS Debates. CEDARS/ASPENS is a joint society of cornea, cataract and refractive surgery specialists, here to discuss some of the latest hot topics in ophthalmology.In recent years, several new techniques have em…
Autologous stem cell transplantation may be feasible for advanced keratoconus
A phase 1 pilot study preliminarily showed the safety of autologous adipose-derived adult stem cell transplantation in the corneal stroma and the ability of these cells to survive in vivo and produce new collagen. This form of cellular therapy could potentially help remodel and strengthen the cornea in patients with keratoconus.
“We undertook this study on the basis of our own preclinical investigation. The purpose is to rehabilitate the biology of the cornea using autologous stem cells. In this first pilot study on human corneas, we specifically aimed at proving (Read more...)
Perceived luminance through small aperture greater than expected
LISBON, Portugal — The perceived brightness with a small aperture is 30% to 60% greater than should be theoretically expected, according to a poster study presented here.
One of the potential issues with small aperture inlays or IOLs is that they reduce retinal illuminance. However, there is a significant history of clinical data showing that patients report less significant reduction in perceived brightness than expected.
“Due to neuroadaptation, the eye with a small aperture is somehow tuning the response and adjusting the difference in brightness,” Pablo Artal, PhD, said
VIDEO: CAPSULaser makes capsulotomy easy and reproducible
LISBON, Portugal – At the European Society of Cataract and Refractive Surgeons meeting, Pavel Stodulka, MD, PhD, speaks about CAPSULaser, a new compact laser for capsulotomy, and the results of his study on 124 eyes.
VIDEO: Translational medicine: From unmet needs to possible solutions, looking at basic science
LISBON, Portugal — At the EuCornea meeting, Paolo Rama, MD, talks about corneal limbal stem cell transplantation and topical nerve growth factor, two long, successful stories in which his role was critical to the happy ending.
Two senators reach bipartisan deal to save health insurance subsidies
Two senators have struck a bipartisan deal to temporarily preserve subsidies for health insurance companies set to be scrapped by President Donald J. Trump, The New York Times reports.Senators Lamar Alexander (R- Tennessee) and Patty Murray (D- Washing…
Court rules Allergan’s Restasis patents invalid, criticizes Native American deal
A federal court ruled Monday that Allergan’s patents for Restasis were invalid “based on obviousness,” opening the door to generic competition.
Patents for Restasis (cyclosporine ophthalmic emulsion 0.05%), Allergan’s dry eye drug that brings in $1.5 billion annually, were set to expire in 2014; however, the company filed additional patents extending protections to 2024.
The ruling from the U.S. District Court for the Eastern District of Texas found the defendants in the case — four generic pharmaceutical companies including Teva Pharmaceutical Industries —
California law may minimally impact drug pricing transparency
Lisa Kroon
California Gov. Jerry Brown approved legislation that will require pharmaceutical companies to give the state advanced notice of, as well as justify, dramatic drug price increases.
The intent of this bill is to increase transparency of drug price increases to the public, Ben R. Handel, PhD, an assistant professor of economics at the University of California, Berkeley and a faculty research fellow at the National Bureau of Economic Research, told HemOnc Today.
“This is something that most people in the health care sector are in favor of and (Read more...)
Topcon’s Pascal Synthesis TwinStar receives 510(k) clearance
The FDA has issued 510(k) clearance for the Pascal Synthesis TwinStar laser photocoagulator from Topcon, according to a company press release.
The device can treat retinal disorders with a 577 nm yellow wavelength or a 638 nm red wavelength. The yellow module allows treatment of a single spot as well as with a variety of patterns and four spot sizes, while the red wavelength is for single spot treatments with two spot sizes, the release said.
“Within ophthalmology, medical laser technology evolves at a rapid pace. Accordingly, offering users a (Read more...)
VIDEO: Customized cross-linking a step forward for well-established technique
LISBON, Portugal — At the EuCornea meeting, Theo G. Seiler Jr., MD, speaks about customized cross-linking and the results of a study in which this new approach is compared with the standard technique.
Bausch + Lomb announces enVista MX60E IOL
Bausch + Lomb introduced the enVista MX60E with StableFlex technology, a hydrophobic acrylic lens with improved material properties to enhance optic recovery.
According to a company press release, the lens features AccuSet haptics to provide interaction with the capsular bag to secure the lens position through its offset design and broad contact angle.
enVista lenses are the only domestically available single-piece hydrophobic acrylic IOLs that are glistening-free. The new IOL offers a continuous 360° square-edge design, which has been shown to reduce posterior capsular opacification
Minimal nasolabial incision effective for nasolabial fold rehabilitation in paralysis
The minimal nasolabial incision technique demonstrated efficacy as a rehabilitation tool for the nasolabial fold in patients with facial paralysis.The retrospective case series included 21 patients with facial paralysis who underwent nasolabial fold mo…
Frail elderly patients comprise 44% of potentially preventable Medicare spending
High-cost frail elderly individuals accounted for 44% of total potentially preventable Medicare spending, despite only comprising 4% of the Medicare population, according to findings published in Annals of Internal Medicine.
“For clinical leaders, finding areas of care where money can be saved and quality improved is an imperative but has often proved difficult,” Jose F. Figueroa, MD, MPH, from Harvard T.H. Chan School of Public Health, and colleagues wrote.
“One approach that has received substantial attention recently has been focusing on high-need, high-cost patients. By