The iris is a delicate, even finicky, tissue that has an important role in our vision. Damage to it can sometimes be surgically repaired using pupilloplasty techniques. My approach is to determine the extent of the damage, measured typically in clock h…
Author: Healio ophthalmology
Skilled pupilloplasty improves patients’ visual function and appearance
Surgical repair of the iris is a frequent procedure for the consultative ophthalmic surgeon. My first introduction to suture repair of the iris came from one of my early mentors, Malcolm McCannel, MD. He developed the so-called McCannel suture technique primarily to help stabilize subluxated iris-supported IOLs following intracapsular cataract extraction in the 1970s. Malcolm also applied his suture technique to repair irises damaged by trauma. He traveled the world teaching his McCannel suture technique with surgical movies, not videos, and often quipped while lecturing that his “reputation hung on (Read more...)
Supracapsular glued IOL in progressive subluxated cataract maintains intact vitreous face
Progressive causes of zonular dehiscence may be associated with late subluxations and dislocations of the IOL. The general strategies to avoid this include either two- or three-point fixation of the capsular bag during primary surgery even in lesser degrees of subluxations or a lensectomy with anterior vitrectomy and scleral/iris fixation of the IOL. The latter leads to anterior hyaloid face and vitreous disturbance with consequent disadvantages.One of the authors (Jacob) described a technique in 2013 (https://www.youtube.com/watch?v=jpkMsVaDvnA) for supracapsular fixation of a glued IOL in order to retain an intact anterior (Read more...)
Match problem with action to correct toric IOL misalignment
Refractive error due to toric IOL misalignment can be addressed if the problem is matched with the appropriate corrective action, according to one surgeon.Toric IOL misalignment has dramatic effects on vision. Rotation of 3° decreases cylinder correction by 10%, 10° by 35% and with 30°, the axis of residual cylinder is rotated to a new axis, usually oblique. Results may be worse than preoperatively even with the same magnitude of cylinder correction.
What pupilloplasty technique do you use most often?
The iris is a delicate, even finicky, tissue that has an important role in our vision. Damage to it can sometimes be surgically repaired using pupilloplasty techniques. My approach is to determine the extent of the damage, measured typically in clock h…
Start your drops: Allergy season has arrived
As a practicing premium eye surgeon in the Midwest, there are really four seasons in the year, and spring represents the start of allergy season and when I recommend to my allergy-suffering patients to start their allergy eye drops.Ocular allergies aff…
Surgeon gives pearls on how to address residual refractive error after toric IOL implantation
Residual refractive error following the implantation of toric IOLs requires a methodic approach, careful evaluation and well-calibrated choice within a range of possible options, according to one surgeon.“This surgery is a commitment but overall yields great satisfaction even if patients might be initially unhappy,” Elizabeth Yeu, MD, said at Hawaiian Eye 2017.
Let’s get bigger? Not so fast — scale your practice intelligently
“All change is not growth, as all movement is not forward.”– Ellen Glasgow
Man referred with headache and unilateral ptosis
A 73-year-old man was referred to the neuro-ophthalmology service for evaluation of headache with associated right upper eyelid ptosis. Two weeks before presentation, he noted the onset of right-sided periorbital headache, which intensified upon lying down. The headache was intermittent but worsened over the subsequent days, and this corresponded with drooping of his right upper eyelid. He went to his local emergency department, where a non-contrast CT scan of his head was unremarkable. The following day he saw an ophthalmologist, and he was presumptively diagnosed with cluster headache.He followed up (Read more...)
Expert considers limits of visual acuity, visibility and optical performance of human eye
What is the farthest a human can see? What is the best recorded visual acuity? How far is the horizon?I am often asked these questions by clinicians and non-ophthalmologists and thought many of you might like to know the answers. In this article, we wi…
Deep pterygium excision can pose surgical challenge
Pterygium surgery can be challenging due to the extent of corneal involvement. In addition, postoperative recurrences can often be more difficult to manage than primary pterygium. Hence, there is a large menu of surgical techniques to choose from to op…
PUBLICATION EXCLUSIVE: Presbyopia treatment in 2017: Where are we?
In this edition of Ocular Surgery News, the OSN Roundtable discusses how presbyopia is becoming a subspecialty of ophthalmology. In this guest commentary, Francesco Carones, MD, weighs in on the topic Looking at the present state of refractive surgery, in which the correction of refractive errors such as myopia, hyperopia and astigmatism has become safe, accurate and precise with outstanding results for most patients, I feel that presbyopia correction still involves challenges and compromises. Think of the procedures we use to correct, let’s say, 2 D of myopia. I can (Read more...)
Mayo Clinic’s ‘medical school of the future’ tops April news
April brought FDA approvals and the passing of one of the ophthalmology world’s most distinguished figures, but the AMA’s announcement that it was working with the Mayo Clinic to revamp medical schools for a new generation of physicians was the most read breaking news story on Healio.com/OSN this month. Here are the top five most read stories in April:
Barrett Suite integrated into Zeiss’ IOLMaster 700
The Barrett Suite, which includes three new IOL power calculation formulas, has been fully integrated into the IOLMaster 700 for more accurate prediction of refractive outcomes, according to a Zeiss press release.The IOLMaster 700 will automatically apply the Barrett Suite’s IOL power calculation formulas, which incorporate the influence of the posterior corneal surface and have been shown to be more accurate in predicting target refraction, the release said.
Nicox reports first quarter highlights
Nicox reported it had cash, cash equivalents and financial instruments totaling 25 million as of March 31 compared with 28.9 million as of Dec. 31, 2016, according to a press release. No revenues were recorded for the first quarter.
Alcon introduces two vitreoretinal surgical technologies
Alcon is launching two vitreoretinal surgical products at the FLOREtina Retina Meeting in Florence, Italy, according to a press release.The Advanced Ultravit beveled high speed probe and the Vektor articulating illuminated laser probe are designed to h…
Secondary analysis of DRCR.net Protocol T compares improvement and worsening rates over 2 years
A secondary analysis of DRCR.net Protocol T data demonstrated significant, sustained improvement rates of both nonproliferative and proliferative diabetic retinopathy at 1 and 2 years with all three anti-VEGF agents, low rates of worsening and relative…
Avedro secures $42 million in funding, opens manufacturing facility
Avedro has secured $42 million in equity and debt financing to commercially expand and develop its product pipeline, the company announced in a press release.Led by HealthQuest Capital, the equity financing also had investments from OrbiMed Advisors an…
Study finds high prevalence of undiagnosed AMD in primary eye care
A study found a high rate of undiagnosed age-related macular degeneration in primary eye care practices and advocated the need for improved detection strategies.Participants were recruited from primary eye care practices in Birmingham, Alabama, and con…
Genetic testing may give molecular diagnoses in pediatric inherited retinal disease cases
In a retrospective case series, a majority of children with inherited retinal disease who underwent genetic testing were found to have a probable or possible molecular diagnosis.Eighty-five children with a diagnosis of isolated or syndromic inherited r…