Paired opposite clear corneal incisions may have a significantly greater refractive effect and more stable surgically induced astigmatism for with-the-rule astigmatism correction compared with against-the-rule astigmatism correction, according to a stu…
There is insufficient evidence that prophylactic NSAIDs alone or in conjunction with corticosteroids reduce vision loss from cystoid macular edema 3 months or more after cataract surgery, according to an American Academy of Ophthalmology report.CME oft…
Summer is over, even for empty nesters like yours truly. It is “back to school” for all of us in the office, too, as many of us enter our busy seasons. Along with the usual sense of excitement in the air that comes with cooler nights and the sights and sounds of activity on the gridiron, we are on the edge of an exciting new age in the treatment of dry eye. Or maybe not. Or only sort of. I am talking, of course, of the impending FDA decision due on the filing of Shire’s new drug application for lifitegrast, a new medicine for the treatment of dry eye.The only thing of which we can be certain is that you will soon become familiar with the heretofore forgotten term “dysgeusia.”
Presbyopia correction is widely considered one of the unmet needs of refractive cataract surgery, particularly at the corneal plane, but cornea-based methods may be viable alternatives to more entrenched lens-based approaches, according to some experts…
Brief exposure to hand-held high-powered blue-light lasers was associated with full-thickness macular hole formation in a group of young male patients, according to a study.Most cases of full-thickness macular hole required surgical intervention, the s…
Patients with pseudoexfoliation syndrome pose significant challenges during cataract surgery: The zonular apparatus is often weak with some degree of phacodonesis, and the pupil tends not to dilate well, limiting access to the cataract. These eyes are at a higher risk of both intraoperative and postoperative complications, which can result in compromises in visual recovery. The technique of cataract surgery in these eyes with small pupils has traditionally involved the use of mechanical pupil expanders such as iris hooks or rings, but there is an alternate method to achieve an excellent and safe outcome.Our patient comes in for consultation after failing the vision test for his driver’s license renewal. He presents with 2 to 3+ nuclear cataracts in both eyes, which are limiting his best corrected vision to 20/50 and even worse with glare testing. Preoperatively his maximum pupil dilation is 4 mm in diameter, and he is noted to have an axial length of 23 mm with an anterior chamber depth of 2.8 mm in each eye. Because the anterior chamber depth is reasonable and not shallow, we can surmise that the zonular apparatus is in reasonable shape without too much laxity. A pearl that I learned from Alan Crandall, MD, is to beware of a shallow anterior chamber in patients with pseudoexfoliation because it usually means that the entire lens-iris diaphragm is loose and pushing forward, thereby shallowing the anterior chamber.