Author: Healio ophthalmology

Corneal transplant yields good visual recovery in children with keratoconus

SAN FRANCISCO — Corneal transplant surgery in pediatric patients with keratoconus resulted in good visual recovery, according to a physician here.“Keratoconus is the most common reason for corneal transplant surgery in older children between the ages of 12 and 18; interestingly, however, there are very few reports in the literature on the long-term results of corneal transplant surgery in children with keratoconus,” Gerald W. Zaidman, MD, said at the American Society of Cataract and Refractive Surgery meeting.

Two trabecular micro-bypass stents reduce IOP in open-angle glaucoma patients

SAN FRANCISCO — The use of two trabecular micro-bypass stents in open-angle glaucoma patients significantly reduced IOP without complications, according to a study presented here.“There is some evidence that more iStents may further lower pressure beyond the simple one stent,” Ike K. Ahmed, MD, FRCSC, said at the American Society of Cataract and Refractive Surgery meeting. Furthermore, the addition of one medication appears effective in lowering IOP in refractory glaucoma cases after trabeculectomy, he said.

Study: MICS with 21-gauge phaco needle yields less surgically induced astigmatism

SAN FRANCISCO — A 21-gauge phaco needle tip has a smaller diameter than a 20-gauge tip, yet it has the same intraoperative efficiency without clogging when used in microincision cataract surgery with transversal ultrasound, a speaker said here.“It provides better postoperative wound morphology and better control of surgically induced astigmatism,” Ahmed Assaf, MD, FRCSEd, said at the American Society of Cataract and Refractive Surgery meeting.

Smile procedure safely, accurately corrects spherical myopia

SAN FRANCISCO — Femtosecond laser-assisted small-incision lenticule extraction safely treated spherical myopia, according to initial clinical trial results presented here.Jon Dishler, MD, FACS, discussed preliminary data from the first U.S. Food and Drug Administration investigational device exemption clinical trial for the ReLEx smile procedure using the VisuMax femtosecond laser (Carl Zeiss Meditec).

Medical mindset influences decision making

SAN FRANCISCO — A pair of authors suggested physicians consider their own “medical mindset” when they or their patients are faced with making medical decisions. “The public has become acutely aware that experts disagree,” Pamela Hartzband, MD, said, citing the wealth of information available via various media and interpreted and disseminated differently. The same data are valued differently because of different mindsets, the authors said.

Intraoperative aberrometry optimizes outcomes of accommodating IOL and LRIs

SAN FRANCISCO — Wavefront-guided accommodating IOL implantation and limbal relaxing incisions offered predictable visual and refractive outcomes, according to a study presented here.At the American Society of Cataract and Refractive Surgery meeting, Robert J. Weinstock, MD, discussed visual and refractive outcomes of the Crystalens AO accommodating IOL (Bausch + Lomb) combined with manual limbal relaxing incisions (LRIs).

Novel IOL suturing technique provides stable scleral fixation

SAN FRANCISCO — A modified IOL suturing technique for scleral fixation has several advantages over a conventional technique, according to a study presented here.The technique uses the Hoffman corneoscleral pocket and enables secure fixation of the IOL haptics without the need to perform conjunctival dissection, Tsukasa Hanemoto, MD, said at the American Society of Cataract and Refractive Surgery meeting.

ASCRS leads advocacy and innovation efforts

SAN FRANCISCO — Ophthalmic leaders stand poised to tackle ongoing clinical and regulatory challenges in the years ahead, Eric D. Donnenfeld, MD, the newly installed president of the American Society of Cataract and Refractive Surgery, said here.Donnenfeld was installed during the opening ceremonies at the annual ASCRS meeting. He accepted the mantle of leadership from his predecessor, David F. Chang, MD.

Femtosecond laser assists bag-in-the-lens IOL insertion technique

SAN FRANCISCO — A stumbling block to inserting a bag-in-the-lens IOL may be overcome with the use of a femtosecond laser, according to a presenter here.The original bag-in-the-lens IOL insertion technique, which is not approved by the U.S. Food and Drug Administration, was designed to prevent posterior capsule opacification in pediatric and adult cataract patients, Ana Paula Canto, MD, said at the American Society of Cataract and Refractive Surgery meeting. However, the technique for bag-in-the-lens IOL insertion is considered difficult because centration depends on an appropriately sized and centered capsulorrhexis.

Improved corrected distance visual acuity reported in study of femto-assisted DALK

SAN FRANCISCO — Benefits of femtosecond laser-assisted keratoplasty, particularly for deep anterior lamellar keratoplasty, include improved corrected distance visual acuity, a decrease in the complication rate, more precise placement of the air needle, and ease of conversion to full-thickness penetrating keratoplasty if Descemet’s membrane is perforated, according to a speaker.Reporting early outcomes of results of femtosecond laser-assisted DALK in 31 eyes, Ijeoma M. Asota, MD, said at the American Society of Cataract and Refractive Surgery meeting, “We did notice an early and steady improvement in corrected distance visual acuity.”

Zeiss introduces Callisto eye system and Forum Viewer app

SAN FRANCISCO — The ability to overlay graphical data on video images when creating precise limbal relaxing incisions and optimizing capsulorrhexis size and shape is a prime feature of the Callisto eye surgical management system introduced here by Carl Zeiss Meditec.Increased efficiency created by the integration of the documentation, workflow support and surgical assistance functions of the system will improve clinical outcomes, Ludwin Monz, PhD, president and CEO of Carl Zeiss Meditec, said at a media briefing at the American Society of Cataract and Refractive Surgery meeting.

Quality of OCT data affects analysis

SAN FRANCISCO — Before accepting optical coherence tomography imaging output as ready for interpretation, the quality of the data needs to be assessed by doing a quick and careful scan analysis, a speaker said here.”Critically analyze the quality of data from imaging devices before interpreting the data,” Vikas Chopra, MD, said in a presentation foreshadowing the pitfalls of OCT imaging at Glaucoma Day preceding the American Society of Cataract and Refractive Surgery meeting.

Experts weigh whether corneal lesions should be removed before or during cataract surgery

SAN FRANCISCO — Corneal lesions should be removed before cataract surgery, one speaker said, while another advocated simultaneous corneal management and cataract surgery.During Cornea Day preceding the American Society of Cataract and Refractive Surgery meeting, Richard S. Davidson, MD, and Maria A. Woodward, MD, debated the merits of successive vs. simultaneous corneal management and cataract surgery.

LRIs, arcuate incisions popular methods to correct residual astigmatism

SAN FRANCISCO — Limbal relaxing incisions and femtosecond laser arcuate incisions are gaining favor as methods to correct residual astigmatism after cataract surgery, a speaker said here.”We are now undergoing a renaissance of LRIs and [astigmatic keratotomies], and these are becoming more and more important in our armamentarium,” Eric D. Donnenfeld, MD, said during Cornea Day preceding the American Society of Cataract and Refractive Surgery meeting.

Higher preop IOP portends greater IOP lowering in glaucoma patients after cataract surgery

SAN FRANCISCO — The only predictive factor that influences the rate of IOP lowering after cataract surgery alone is preoperative IOP, according to a speaker.”Almost everybody gets a little bit of lowering of IOP, but those with the highest IOP get the most IOP lowering,” Steven L. Mansberger, MD, MPH, said at Glaucoma Day preceding the American Society of Cataract and Refractive Surgery meeting here.

Agents and preservatives both influence trabeculectomy outcome

SAN FRANCISCO — While preservatives used in topical agents contribute to exacerbating ocular surface disease that may affect the success of trabeculectomy, the agents themselves may also be contributors, according to a speaker here.Preservatives do have desirable attributes, Douglas J. Rhee, MD, said at Glaucoma Day preceding the American Society of Cataract and Refractive Surgery meeting.