The American Academy of Ophthalmology has identified five routine tests and treatments that ophthalmologists and patients should discuss in order to determine their necessity, according to a news release.Taking part in the Choosing Wisely campaign to r…
Author: Healio ophthalmology
Accelerated corneal cross-linking may prevent astigmatism after cataract surgery
WARSAW, Poland — Accelerated corneal cross-linking may be employed in cataract surgery to manipulate clear corneal incisions and prevent surgery-induced astigmatism, according to one surgeon.”Clear corneal incisions produce dramatic changes in topometric maps. These astigmatic changes may go away with time but may otherwise be a factor of poor visual function, especially with multifocal or toric lenses,” John Kanellopoulos, MD, said at an industry-sponsored symposium held during the winter meeting of the European Society of Cataract and Refractive Surgeons.
New aspheric aberration profile shows safety, efficacy in treatment of hyperopic astigmatism
WARSAW, Poland — Aspheric femtosecond LASIK offers a reliable method for correction of hyperopic astigmatism, according to one surgeon.The prevalence of hyperopia tends to decline with age, but latent forms often become significant with the onset of presbyopia. Laser treatment is a well-established procedure but not as straightforward as it is for myopic correction, Thomas Kohnen, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
Improvements in multifocal IOLs increasing opportunity for spectacle independence
WARSAW, Poland — Steady advances in multifocal IOL technology could make monofocality obsolete in the near future, according to a speaker.”Recent improvements and new designs have solved or minimized the problems of multifocal IOLs, and new options like the toric component, the low near power and the trifocal technology have increased the opportunities for spectacle independence,” Roberto Bellucci, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
Intracorneal silicone injection may offer pain relief in eyes with bullous keratopathy
WARSAW, Poland — Intracorneal injection of a transparent, biocompatible hydrophobic material is a fast, minimally invasive and promising new technique for the treatment of bullous keratopathy, according to a specialist.The ideas was first developed by George D. Kymionis, MD, PhD, who observed during vitreoretinal surgery that silicone oil that penetrates into the anterior chamber works as a hydrophobic barrier, Ioannis G. Pallikaris, MD, PhD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
Optimized beam profile increases efficacy of corneal cross-linking
WARSAW, Poland — The safety profile of corneal cross-linking has been confirmed through more than 15 years of follow-up, and continuous innovation has increased efficacy, according to a speaker.Summarizing cross-linking results to date and current complication rates at the winter meeting of the European Society of Cataract and Refractive Surgeons, Theo Seiler, MD, PhD, said that 1% of eyes experience two lines of vision loss. Recognized risk factors are age older than 35 years and preoperative best corrected visual acuity greater than 20/25.
Surgeon discourages combining DMEK with phaco
WARSAW — Phakic eyes fare better than pseudophakic eyes after Descemet’s membrane endothelial keratoplasty, and given the low incidence of induced cataract development, there is no reason to combine DMEK with phaco, according to one surgeon. Fearing that endothelial grafts may be damaged by postoperative cataract development and subsequent phaco surgery, surgeons sometimes choose to combine the two procedures, Jack Parker, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
Dual-optic accommodating IOL may offer premium technology without halo, glare
WARSAW, Poland — A dual-optic accommodating IOL may be the best option for many patients who ask to be treated with premium procedures and technologies, according to one surgeon.“Some patients come to my office and tell me that they want a premium technology but don’t want the problems their friends are experiencing, namely halos and glare. These are the perfect candidates for the [Abbott Medical Optics] Synchrony lens. I explain to them that they are likely to need some add for reading books, but computer vision will be perfect,” Matteo Piovella, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
New aberration-optimized algorithm leads to good results in hyperopic patients
WARSAW, Poland — A new aberration-optimized SupraCor algorithm leads to good results in hyperopic patients, according to one surgeon. A prospective study of 46 patients with refraction between +0.5 D and +4 D and astigmatism up to 3 D was presented at the winter meeting of the European Society of Cataract and Refractive Surgeons. A near addition of +2 D or more was needed. Patients underwent LASIK with the Femto LDV Crystal line (Ziemer) for flap creation. “In the hyperopic patient, you initially perform the correction for far, and in the 3-mm central zone, you then perform the addition for near,” Bojan Pajic, MD, said.
Useful vision restored in retinitis pigmentosa patients who received subretinal implant
More than half of patients with severe retinitis pigmentosa who received the Alpha IMS subretinal implant recovered functional vision, according to results from a second human clinical trial of the device. The trial examined nine patients for a 3- to 9-month period after subretinal implantation of the Alpha IMS (Retina Implant), a 3 mm × 3 mm, 1,500-pixel device designed to restore vision without externally visible equipment.
Study: Low-price strategy in refractive surgery has no benefits, large profit losses
WARSAW, Poland — A low-price strategy in refractive surgery leads to no benefits and large profit losses for health care providers, according to a study carried out at the Bellevue Eye Clinic in Kiel, Germany. “We found that the level of price sensitivity is low amongst candidates for refractive surgery. About 12% of LASIK patients and 20% of refractive lens patients paid less than patient-related maximum willingness to pay,” Tim Herbst, project manager, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
AS-OCT facilitates decision making regarding surgical re-intervention after DMEK
WARSAW, Poland — Anterior segment optical coherence tomography showed high predictive value in evaluating graft adherence status and may facilitate decision making regarding surgical re-intervention after Descemet’s membrane endothelial keratoplasty.“Graft detachment is the most frequent complication in endothelial keratoplasty, occurring in about 10% of our cases at the NIIOS clinic in Rotterdam,” Marina Rodríguez Calvo de Mora, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
Enhanced surgical technique optimizes safety and efficacy of corneal inlay
WARSAW, Poland — A new surgical technique for insertion of the Icolens corneal inlay proved safe and effective in a series of patients, according to one speaker.“The procedure is performed under topical anesthesia and involves two stages. Stage one is creation of the corneal pocket using the Femto LDV laser (Ziemer Ophthalmics), and stage two involves insertion of the hydrogel inlay using a unique preloaded deployment device,” Sarah Moran, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
New multifocal IOLs still show gender differences in satisfaction rates
WARSAW, Poland — Average levels of satisfaction with new multifocal IOLs still show differences between women and men, according to one surgeon. The main reason for dissatisfaction after implantation in women is poor near vision, while glare and halos during night driving prevail among men. “In our previous study of 1,600 patients, we found significant differences in the acceptance of [multifocal] IOLs between males and females. More recently we wondered if there would still be a difference in the acceptance rates of the new [multifocal] IOLs in a time where traditional gender role models are gradually disappearing,” Magda Rau, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
Quality of surgery, surgeon reputation influence decision to undergo refractive laser-assisted cataract surgery
WARSAW, Poland — Quality of medical performance, reputation of the surgeon and fear of surgery seem to be the main factors in patients’ decision to undergo refractive laser-assisted cataract surgery, or RELACS, according to a study carried out at a large private clinic in Germany.“Price plays a secondary role. These patients agree to co-payment, and the extra charge seems to be of little concern to them,” Tim Herbst, project manager, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
Pay-for-performance approach proves beneficial in German clinic
WARSAW, Poland — A pay-for-performance system recently introduced at Bellevue Eye Hospital, Kiel, Germany, could set a model for quality-based payment in ophthalmology.“In German hospitals, we receive a fixed price for procedures. For cataract surgery, it is on average €450 to €500, independent of the quality of the service we provide,” Jörg Förster, CEO of Bellevue Eye Hospital, said at the winter meeting of the European Society of Cataract and Refractive Surgeons. “A goal of modern health care is to develop a payment system in which payment is geared not only to the expenses we have, but also to the quality of care we provide.”
Cataract surgery in patients previously implanted with iris-claw lenses leads to good refractive results
Femtosecond laser cataract surgery enhances performance of light-adjustable lens
Intraoperative anterior segment OCT accurately predicts IOL position after surgery
Second-generation micro-bypass stent significantly lowers IOP, medication intake
WARSAW, Poland — Results of the Micro-Invasive Glaucoma Surgery Study Group with the second-generation trabecular micro-bypass iStent inject implanted with a single-use injector showed a significant decrease in IOP and number of medications with a favorable safety outcome.The iStent inject (Glaukos) is single-piece, miniature, collar button-shaped heparin-coated titanium stent, implanted ab interno into Schlemm’s canal. Multiple lateral lumens are designed to provide an exit route for the aqueous from the anterior chamber, Manfred Tetz, MD, explained at the winter meeting of the European Society of Cataract and Refractive Surgeons. “Results are significantly better compared with the previous-generation iStent,” he said.