SAN FRANCISCO — Thorough assessment and patient counseling are critical to making accurate IOL power calculations in eyes that previously underwent myopic LASIK, a speaker said here.During Cornea Day, which preceded the American Society of Cataract and Refractive Surgery meeting, Sumit Garg, MD, explained the various factors that can complicate IOL calculations in post-LASIK eyes.
Author: Healio ophthalmology
Piggyback IOLs an option for managing postop refractive error
SAN FRANCISCO — Secondary or piggyback IOLs are a viable alternative to other methods of managing refractive error after cataract surgery in eyes that have had previous laser refractive surgery, a speaker said here.Warren E. Hill, MD, shared pearls on refractive assessment and lens choice during Cornea Day preceding the American Society of Cataract and Refractive Surgery meeting.
Intrastromal ‘sliding’ technique effectively addresses astigmatism following anterior keratoplasty
BASSANO DEL GRAPPA, Italy — A manual technique combining arcuate incisions and horizontal separation within stromal layers can effectively address astigmatism following anterior corneal transplantation, according to one surgeon.This technique, according to Massimo Camellin, MD, can be applied to address astigmatic depression areas, where the donor cornea has sunk below the recipient level.
Recurrence of virus-related keratitis persists despite prophylactic treatment
SAN FRANCISCO — Significant variation in treatment and prophylaxis management was seen among clinicians treating keratitis associated with herpes simplex virus and herpes zoster virus, according to a study.A retrospective review that documented demographics, treatment, prophylaxis and recurrence included 193 eyes of 188 patients who presented with HSV or HZV keratitis. Of patients who were on a prophylactic regimen, there were no differences seen between groups regarding the rate of recurrence; however, for patients not on such a regimen, patients with HSV had more recurrences, Halah M. Ali, MBBS, MSc, said at the American Society of Cataract and Refractive Surgery meeting.
Protecting endothelium critical in cataract surgery with concurrent Fuchs dystrophy
SAN FRANCISCO — Cataract surgery alone is preferable to performing it in conjunction with endothelial keratoplasty in cases of concurrent cataract and Fuchs’ endothelial dystrophy, a surgeon said here. During Cornea Day preceding the American Society of Cataract and Refractive Surgery meeting, Francis S. Mah, MD, presented pearls on protecting the endothelium in cataract surgery with concomitant Fuchs’ dystrophy.
Dry eye signs and symptoms found in patients with fibromyalgia
SAN FRANCISCO — Fibromyalgia patients present with signs and symptoms of evaporative and aqueous deficient dry eye disease, according to a physician here.”Fibromyalgia patients should be routinely questioned as to any signs or symptoms of dry eye and referred for a comprehensive evaluation to determine the nature of their dry eye disease and the most appropriate therapeutic course,” Jack V. Greiner, DO, PhD, said at the American Society of Cataract and Refractive Surgery meeting.
Hydrogel corneal inlays show promise for treatment of presbyopia
SAN FRANCISCO — Hydrogel corneal inlays may be a potential treatment for presbyopic patients, resulting in no loss of binocular vision and corneal clarity, according to a physician here.”The inlay has the effect of changing the anterior curvature of the cornea,” Stephen G. Slade, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Femtosecond PK with zigzag incision yields stable visual recovery
SAN FRANCISCO — Early suture removal after penetrating keratoplasty with a femtosecond laser-generated zigzag incision afforded stable visual recovery and minimal astigmatism, a speaker said here.”Conventional corneal transplantation has been around for quite some time, and while it is a very good procedure, it does have some limitations, such as long recovery, suture-in-and-out astigmatism and poor corrected distance visual acuity,” Matthew Wade, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Generalized polyangiitis may pose as atypical conjunctivitis
SAN FRANCISCO — Generalized polyangiitis can mask itself as atypical conjunctivitis, and high clinical suspicion for vasculitis should warrant immediate additional evaluation and tissue biopsy, according to a physician here.”Critical review of radiologic images and tissue biopsies can aid in the accurate diagnosis of this systemic disease because missing the diagnosis can be a fatal mistake,” Evan C. Pike, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Surgeons discuss present and future of femtosecond laser-assisted cataract surgery
BASSANO DEL GRAPPA, Italy — Femtosecond laser-assisted cataract surgery will become the state of the art in the coming years, although further developments of the technique and technology upgrades are needed, according to a panel of surgeons speaking at a meeting at the San Bassiano Hospital here. “It’s still early days, and the technique is far from being perfect. As it is now, it requires longer times, and we don’t know yet how to improve some of the weak points of the procedure, such as hydrodissection. However, problems are there to be solved. We only need time, as we did when we switched from ECCE to phaco,” Simonetta Morselli, MD, the meeting organizer, said.
Femtosecond LASIK and smile yield similar outcomes
SAN FRANCISCO — Small-incision lenticule extraction and femtosecond laser-assisted LASIK offered comparable visual and refractive outcomes, a speaker said here.At the American Society of Cataract and Refractive Surgery meeting, Angie De La Mota, MD, presented results of a randomized study comparing visual, refractive, anatomic and sensory outcomes with small-incision lenticule extraction (smile) and femtosecond LASIK.
Almost one-fourth of sutured cataract wounds leak, study finds
SAN FRANCISCO — More than half of clear corneal incisions and almost one-quarter of sutured cataract wounds leaked when tested with calibrated reproducible force, according to a study presented here.“Even after stromal hydration, 60% of corneal wounds leaked when challenged,” John A. Hovanesian, MD, FACS, said in presenting the study he conducted with Samuel Masket, MD, during the American Society of Cataract and Refractive Surgery meeting.
Diagnostic errors called most harmful, costly medical mistakes
Misdiagnoses were responsible for the costliest and deadliest portion of US malpractice claims during the last 25 years, according to new research.After reviewing 350,706 malpractice payments through the National Practitioner Data Bank (1986 to 2010), …
Corneal cross-linking faces various regulatory hurdles in US
SAN FRANCISCO — Corneal collagen cross-linking faces numerous regulatory approvals in the United States by virtue of being a drug-device combination, an expert said here.The procedure is approved in the European Union and other regions but is not approved in the U.S. Several clinical trials are ongoing.
Novel method of pterygium surgery optimizes visual, cosmetic outcomes
SAN FRANCISCO — A sutureless method of pterygium surgery offers optimal cosmetic results the day after surgery, according to a study presented here. The method, using amniotic membrane, yields high patient satisfaction, Arun C. Gulani, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Ab interno implant offers alternative method to reduce IOP
SAN FRANCISCO — An innovative minimally invasive ab interno subconjunctival gelatin implant reduced IOP in glaucoma patients, according to study results presented here.”It’s minimally invasive on one side and highly effective on the other,” Inga S. Kersten-Gomez, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Capsule-sparing procedure has effective results in complex pediatric eyes
SAN FRANCISCO — Phacoemulsification with in-the-bag implantation of a scleral-sutured modified capsular tension ring and an IOL is a practical procedure that preserves capsular and anterior hyaloid anatomy and avoids unnecessary vitrectomy, according to a physician here.”It is a better choice in the pediatric demographic, which is prone to blunt trauma,” Mauricio A. Perez, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Customized PRK improves astigmatism after PK
SAN FRANCISCO — Topographically guided PRK was effective in treating irregular astigmatism after penetrating keratoplasty, according to a study presented here. Best corrected visual acuity improved in almost half of all eyes, Simon P. Holland, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Reducing vacuum and aspiration rate minimizes post-occlusion surge
SAN FRANCISCO — There are ways to minimize post-occlusion surge during phacoemulsification, according to a speaker. “Surge is something we all need to recognize as surgeons. We need to know what it is; we need to know how to manage it,” Timothy P. Page, MD, said at the American Society of Cataract and Refractive Surgery meeting here.
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.