WAIKOLOA, Hawaii — Endothelial keratoplasty procedures only replace the part of the cornea that is dysfunctional, making them potentially safer and yielding better visual results compared with penetrating keratoplasty, a speaker said here.“As we get more experience, we are becoming more exact in the way that we do the tissue replacement,” Francis W. Price Jr., MD, said at Hawaiian Eye 2013.
Author: Healio ophthalmology
Various treatments available for myopic traction maculopathy
WAIKOLOA, Hawaii — Multiple options are available to treat myopic traction maculopathy, a speaker said here.“The pathogenesis of myopic traction maculopathy is not completely understood, but I think it’s a very important clue that this virtually always occurs within a posterior staphyloma,” Mark W. Johnson, MD, said at Retina 2013.
Rate of endophthalmitis after cataract surgery remains low
WAIKOLOA, Hawaii — Endophthalmitis after cataract surgery is uncommon, but it does happen, according to a speaker, with reported rates varying from 0.03% to 0.15%.When looking back at a single institution’s experience over a 15-year period during which nearly 60,000 cataract surgeries were performed, only 16 cases (0.03%) were identified, OSN Retina/Vitreous Board Member Andrew A. Moshfeghi, MD, MBA, said at Hawaiian Eye 2013.
Intraocular lymphoma has many clinical implications
WAIKOLOA, Hawaii — The rarity of intraocular lymphoma causes concern and has many clinical implications for physicians, a speaker said here.According to Janet L. Davis, MD, the largest clinical implication of intraocular lymphoma is that the disease is rare.
Genetic testing identifies mutations known to cause inherited glaucoma
WAIKOLOA, Hawaii — Genetic testing is available to identify mutations in genes known to cause dominant and recessive forms of inherited glaucoma, a speaker said here.According to Janey L. Wiggs, MD, PhD, genetic testing for early-onset forms of glaucoma can provide valuable diagnostic and prognostic information.
Study: Pseudophakic dysphotopsia impedes function
WAIKOLOA, Hawaii — Researchers have found a correlation between pseudophakic dysphotopsia and impeded function, suggesting that the unwanted images are more than just an annoyance, according to a speaker here.Of 2,953 pseudophakic candidates considered for a visual quality study, only 70 met the criteria of having uncomplicated surgery, 20/20 results and no obvious ocular disease — no dry eye, no posterior capsule opacification (PCO), no blepharitis and no ocular complaint.
OCT may detect pre-perimetric changes in glaucomatous eyes
WAIKOLOA, Hawaii — Optic nerve head microcirculation is reduced in glaucoma patients, a speaker said here.“Conventionally, OCT is used to measure structure with micron precision, and that has been very useful in terms of characterizing the structure of the optic nerve head, the nerve fiber layer and the ganglion cell complex,” David Huang, MD, PhD, said at Hawaiian Eye 2013. “We developed a technique where we decomposed the OCT image into several spectral bands and analyzed them separately and recombined them to enhance a signal of flow.”
Individualized glaucoma surgery offers effective results
WAIKOLOA, Hawaii — Glaucoma surgery should be individualized to each patient’s specific needs and form of glaucoma, a speaker said here.According to Thomas W. Samuelson, MD, OSN Glaucoma Section Editor, reducing glaucoma surgical complications is now easier for physicians due to the availability of the correct surgical tools.
Goniotomy, trabeculotomy produce most successful results in pediatric glaucoma
WAIKOLOA, Hawaii — Goniotomy and trabeculotomy are the most effective surgical methods for infantile glaucoma, a speaker said here.“The first thing that’s most important in these surgeries is visualization,” Ken K. Nischal, MD, FRCOphth, said at Hawaiian Eye 2013. “It’s really important to understand that the goniolens you use will affect how easy or how difficult the procedure becomes.”
Diagnostic vitrectomy for uveitis indicated to obtain tissue for biopsy
WAIKOLOA, Hawaii — The need for a biopsy specimen in a patient with uveitis is an indication for diagnostic vitrectomy, a somewhat technique-based but mostly disease-based procedure, according to a speaker.“Figuring out the disease and what you need to do to control it is an essential part of the surgery, because the disease, in many cases, is going to be ongoing even after the surgical procedure,” Janet L. Davis, MD, told colleagues at Retina 2013.
Trypan blue staining aids in performing proliferative vitreoretinopathy surgery
WAIKOLOA, Hawaii — Despite advances in vitreoretinal surgical techniques, proliferative vitreoretinopathy remains an obstacle to successful surgical repair. “It’s actually responsible for 75% of all primary surgical failures,” Sophie J. Bakri, MD, said at Retina 2013.
Small globe size, high concentration of VEGF in vitreous may be risk factor for early AMD
HYDERABAD, India — Small globe size, possibly in correlation with a thicker vitreous and a higher concentration of VEGF, may be a major risk factor for early age-related macular degeneration, according to a speaker here. “In the Beijing Eye Study, hyperopia, short interscleral spur distance and small optic disc size, besides older age, were found to be the main risk factors associated with early AMD. This points to a small globe size, and we may speculate that the vitreous plays a role,” Jost B. Jonas, MD, said at the joint meeting of the Asia-Pacific Academy of Ophthalmology and All India Ophthalmological Society.
New eye banking model may bridge gap between donor cornea supply, demand
HYDERABAD, India — A three-tier eye banking model aims to optimize existing resources in India and make quality corneas available to all segments of the population, a speaker said here. The new model, already approved by the Indian Ministry of Health, may bridge the gap that currently exists between donor cornea need and availability.
Precut corneal tissue offers better safety, quality assurance
HYDERABAD, India — Corneal tissue precut by an eye bank provides better safety and quality assurance despite some disadvantages, according to a speaker here. “Precut tissue entails higher costs, needs swelling and a time interval of over 24 hours before transplantation. On the other hand, it is thoroughly examined and analyzed by slit lamp and specular microscopy. Only the best and safest lenticules are used in the OR,” Howard Cajucom-Uy, MD, said at the joint meeting of the Asia-Pacific Academy of Ophthalmology and All India Ophthalmological Society.
Study chair details top 10 findings of CATT
WAIKOLOA, Hawaii — The lead author of the Comparison of Age-Related Macular Degeneration Treatment Trials presented the top 10 study findings here.“In general, physicians who use a lot of Lucentis tend to look at this data and see differences, and Avastin users tend to look at this data and see similarities,” Daniel F. Martin, MD, said at Retina 2013.
Sustained IOP lowering a main reason to perform phaco in glaucoma patients
WAIKOLOA, Hawaii — Among the reasons to perform phacoemulsification in patients with glaucoma, sustained lowering of IOP is at the top of the list, according to a speaker.“The IOP-lowering effect has been known for quite some time,” Kuldev Singh, MD, said at Hawaiian Eye 2013, citing literature dating back to 1996. Furthermore, the literature suggests that this pressure-lowering effect also occurs in eyes without glaucoma that undergo phacoemulsification, and the effect is even greater in eyes with exfoliation syndrome.
Expert shares preparation tips for undertaking iStent implantation
WAIKOLOA, Hawaii — Success is achieved with proper preparation, a presenter told colleagues interested in learning what to expect when implanting a trabecular micro-bypass shunt for the first time.“Planning for the operating room is extremely important,” Malik Y. Kahook, MD, said at Hawaiian Eye 2013.
Polypoidal choroidal vasculopathy a variant of type 1 neovascularization
WAIKOLOA, Hawaii — Polypoidal choroidal vasculopathy is found above the Bruch’s membrane and is a variant of type 1 neovascularization, a speaker said here.According to K. Bailey Freund, MD, polypoidal choroidal vasculopathy (PCV) is not just a distinct abnormality of the inner choroidal vasculature, as was initially thought.
Simple surgical steps give femtosecond laser accuracy to conventional cataract surgery
WAIKOLOA, Hawaii — To improve accuracy of conventional cataract surgery, mark the limbal relaxing incision with the patient upright, mark the capsulotomy, and be compulsive about cleaning up epithelial cells, a speaker said here.In a presentation at Hawaiian Eye 2013, John A. Hovanesian, MD, FACS, presented data on optimizing cataract surgery outcomes to achieve similar accuracy as obtained by femtosecond lasers.
Severity of glaucoma key to choosing surgical approach
WAIKOLOA, Hawaii — Choosing a surgical option for the patient with both glaucoma and cataract depends on the type and severity of glaucoma, according to a presenter here.Options are cataract surgery alone, a combined phacoemulsification and glaucoma procedure, or a two-stage surgery, with either the glaucoma procedure first and then the cataract extraction later or the cataract extraction first and the glaucoma procedure, if necessary, later.