Lynda Charters

The Tecnis multifocal IOL (Advanced Medical Optics) has been shown to be highly effective for patients with different clinical needs, such as in patients undergoing cataract surgery and IOL implantation, those with presbyopia, and in those with hyperopia. Three studies presented at the annual meeting of the American Society of Cataract and Refractive Surgery reported the results with this IOL.

Somain, France-The new Akreos microincision IOL (Bausch & Lomb) with its new haptic design can be implanted without difficulty through a 1.8-mm incision, combining all the benefits of the Akreos design with those of smaller corneal incisions. The IOL provides good-quality vision and intracapsular stability, according to Thierry Amzallag, MD, who reported the 6-month results of a pilot study.

Rochester, NY-The Rochester nomogram for custom LASIK provided significantly better postoperative visual acuity, better predictability, and reduced range of postoperative spherical equivalent compared with the previous FDA study in eyes with greater degrees of myopia, according to Manoj Subbaram, PhD.

Houston-Hyperopia treated with the wavefront-optimized Allegretto Wave excimer laser (WaveLight) achieved good long-term stability, even in patients with 4 to 6 D of hyperopia. The wavefront-optimized platform also achieved excellent outcomes for hyperopia up to 6 D with 5 D of cylinder, reported Charles R. Moore, MD.

The topographically guided algorithm in the EC-5000 CX (Nidek) excimer laser provided a good visual outcome for patients with myopia, with 95% of patients achieving 20/20 or better visual acuity and no induction of total aberrations, according to a study by Mihai Pop, MD.

Minneapolis-Wavefront surface ablation seemed to be a safe and effective treatment for patients with substantial degrees of coma or trefoil in the early follow-up period. The 1-year data in a small number of eyes showed that the results remained stable, according to David R. Hardten, MD.

Miami-Medical errors in refractive surgery can be avoided by engaging in a fastidious checking and rechecking of the patient, the site, and the chart before entering the surgical suite, according to Sonal B. Dav?, MD.

San Francisco-Early experience with the use of corneal onlays for refractive correction seems to indicate that extracellular matrix substitutes can be made into onlays that can integrate functionally within host corneas. Epithelial pockets can be created and there is potential for these lenticules to be useful future supplements for, or alternatives to, laser-based refractive correction, according to W. Bruce Jackson, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

Fort Lauderdale, FL-Abnormalities in the retinal circulation of patients with Alzheimer's disease have been demonstrated for the first time. It is likely that the mechanisms producing reduced blood flow in the retina are related to those that produce cerebral blood flow abnormalities in Alzheimer's disease, Gilbert T. Feke, PhD, reported at the annual meeting of the Association for Research in Vision and Ophthalmology.

Fort Lauderdale, FL-Key findings in the optic disc and retina may make it possible for clinicians using optical coherence tomography (OCT) to distinguish between early glaucoma and optic neuropathy in patients with mild Alzheimer's disease.

Fort Lauderdale, FL-A study that compared the toxicity of two antiglaucoma drugs, travoprost 0.004% (Travatan, Alcon Laboratories) without the preservative benzalkonium chloride with that of latanoprost 0.005% (Xalatan, Pfizer) with 0.02% benzalkonium chloride, found that the absence of the preserving agent was associated with significantly less toxicity in immortalized human corneal epithelial cells, reported Richard W. Yee, MD, at the annual meeting of the Association for Research in Vision and Ophthalmology.

Charleston, SC-The brimonidine 0.2%/ timolol 0.5% fixed combination (Combigan, Allergan) administered twice daily is as effective as the concurrent use of brimonidine and timolol and is significantly more effective than monotherapy with either brimonidine three times daily or timolol twice daily, according to E. Randy Craven, MD, who presented his results at the American Glaucoma Society meeting here. The fixed combination is also superior to brimonidine monotherapy in long-term safety and the development of fewer ocular allergies, Dr. Craven said.

Fort Lauderdale, FL-The Trabectome procedure (NeoMedix Corp.) with its low complication rate and high success rate suggests that it might be a promising primary surgical intervention for improved surgical management of patients with open-angle glaucoma (OAG), according to Sameh Mosaed, MD, at the annual meeting of the Association for Research in Vision and Ophthalmology here.

San Diego-An evaluation of the first group of patients to undergo conductive keratoplasty (CK) performed by Ronald Friedman, MD, indicates that the procedure can be safely used to treat hyperopia and presbyopia and is easily introduced into an average-volume practice with a refractive and cataract base.

Three months after the . . . procedure, there was a substantial reduction in higher-order aberrations, coma, and spherical aberration.

San Diego-Cold ultrasound technology [WhiteStar, Advanced Medical Optics Inc. (AMO)] allows the efficient removal of all densities of cataracts and is as safe as a pulsed laser microincision phacoemulsification system. A major advantage of the cold ultrasound system is that it dramatically reduces the phacoemulsification time compared with laser phacoemulsification.

San Diego-The Artisan Hyperopia IOL (Ophtec BV) appears to be safe, effective, and stable for the treatment of high and extreme hyperopia, according to Edward E. Manche, MD, who reported the interim results of the FDA phase III clinical trial at the American Society of Cataract and Refractive Surgery annual meeting.

San Diego-The Amadeus Microkeratome (Advanced Medical Optics Inc. [AMO]) boasts a narrow 9-mm suction ring, which allows LASIK to be performed ona wider range ofpatients comparedwith other microkeratomes that do not have this size ring available. Y. Ralph Chu, MD, who uses this suction ring almost exclusively, described his experience at the American Society of Cataract and Refractive Surgery annual meeting.

An off-label use of the CustomCornea procedure (Alcon Laboratories) to re-treat symptomatic eyes of patients who had undergone a previous refractive procedure produces dramatic reductions in visual symptoms, according to James J. Salz, MD.

San Diego-Inducing negative spherical aberration may be desirable after conductive keratoplasty (CK). Results of a study showed that patients with negative spherical aberration after CK met the target refractive error and target vision compared with patients with positive spherical aberration, according to Stephen Pascucci, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

San Diego-Creating a flap with the IntraLase laser (IntraLase Corp.), regardless of the type of ablation that followed IntraLase flap creation, seemed to improve the visual outcomes significant-ly compared with creating a flap with a microkeratome. The IntraLase laser proved to be safe and effective and may have had a greater impact on outcomes in clinical practice than using customized wavefront-guided ablations, according to Richard Launer, MD.

San Diego-Conductive keratoplasty (CK) is proving to be a versatile procedure that also can be used as an off-label procedure to enhance the vision of patients who have undergone cataract extraction. The visual results were excellent and patients expressed satisfaction. CK may be a more attractive procedure for this patient group because of safety and economic considerations, according to Louis D. "Skip" Nichamin, MD.

San Diego-Implantation of the AcrySof ReSTOR (Alcon Laboratories Inc.) anterior chamber, angle-supported, phakic refractive IOL is a "very straightforward procedure," according to Michael C. Knorz, MD.

San Diego-There is a great variety of instruments and displays commercially available to assess corneal topography. The array of instrumentation makes it increasingly difficult to interpret corneal topography maps correctly. During the Innovator's Session of the recent annual meeting of the American Society of Cataract and Refractive Surgery, Stephen D. Klyce, PhD, introduced a device-independent neural network-based tool that automatically interprets corneal topography maps.

San Diego-The Artisan Phakic IOL (Ophtec BV, Groningen, The Netherlands) provides overall high satisfaction for patients with moderate to high myopia. Night vision problems from higher-order aberrations, decentration of the lens, and pupil size versus the optic disparity of the IOL should be investigated further, according to Randy Nuijts, MD.

San Diego-The I-CARE anterior chamber foldable phakic IOL (CORNEAL, Paris, France) seems to provide excellent anatomic and visual results 2 years after implantation.

San Diego-Phakic anterior chamber IOLs affect the biometric measurement of axial length, which results in clinically significant errors in IOL power calculations in patients who need to undergo cataract surgery. Gerald Zaidman, MD, described such a patient and offered suggestions for managing this complicated problem here at the American Society of Cataract and Refractive Surgery.

Minneapolis-Differentiating ischemic optic neuropathy from optic neuritis can be problematic. The type of visual field defect, the presence or absence of pain, radiologic differences distinguishing between the two, and the degree of visual recovery, among others, may be helpful clues, Howard D. Pomeranz, MD, PhD, suggested.

San Diego-The M2 130-?m disposable head (Moria) performed well in a small series of patients who underwent LASIK for the treatment of myopia and myopic astigmatism. The faster surgical path used with this device may be responsible for induction of less higher-order aberration.

Lausanne, Switzerland-Disorders of accommodation can be caused by disruption of neuroregulation. While many patients present with an insidious and mild accommodative insufficiency, often accompanying a systemic illness, the acute onset of severe and bilateral loss of accommodation is a more serious condition and may indicate the presence of a midbrain lesion.