Cataract

Different corneal diseases present different challenges to achieving the desired refractive outcome after cataract surgery. Cornea specialist Dasa V. Gangadhar, MD, highlights measures to consider in various situations.

In his latest blog, Mark Packer, MD, FACS, CPI, defends why doctors should not allow the restrictions of third party payers on reimbursement for cataract surgery to drive your diagnosis or your recommendations for treatment, as diagnosis and treatment must remain the surgeon’s sole responsibility if our profession is to retain any of its natural inherent authority.

A new capsule polisher can efficiently polish and sweep debris from the entire anterior capsule.

The unique properties of a light-adjustable lens are designed to provide predictable results and customized refractive treatments.

A new sequentially shifting wavefront device for intraoperative aberrometry provides continuous feedback on refraction during cataract surgery.

In crowded eyes, removal of vitreous through a one-port pars plana vitrectomy is the only viable strategy to deepen the anterior chamber and allow safe phacoemulsification, according to R.J. Mackool Jr., MD.

Five pearls should be considered to protect the endothelium after cataract surgery. These involve consideration of the phacoemulsification techniques and technology, use of viscoelastics, irrigation and aspiration techniques, intracameral medications, and postoperative medications.

Better management of white cataracts with these pearls can help avoid complications like the Argentinian flag sign.

Intraoperative aberrometry may reduce refractive surprises and result in a higher percentage of happy patients following cataract surgery, particularly those who had undergone previous corneal refractive surgery and in those planning for a toric IOL.

Follow-up to 3 years in a study of eyes undergoing combination cataract surgery with implantation of a single microbypass trabecular stent shows a 36% reduction from baseline mean medicated IOP and 84% reduction in daily medication use.

New tools are facilitating repositioning of a misaligned toric IOL. The corrective procedure is best undertaken sooner than later.

A disposable irrigation/aspiration handpiece is designed for the soft removal of cataracts following femtosecond laser fragmentation without the use of ultrasound energy. Dee Stephenson, MD, shares personal experiences with the integration of this technology into practice.

Stephen S. Lane, MD, describes his technique for using an ocular sealant, as well as cases where he finds it useful and superior to sutures.

Examining how utilizing an intravitreal transzonular injection can help patient compliance.

In patients who present with a cataract, certain histories should raise suspicion about existing damage to the posterior capsule or an increased risk for capsule rupture intraoperatively. Armed with that information, cataract surgeons can implement proper strategies for cataract removal and IOL implantation.

ACTIVATE System Control Software for the Stellaris Vision Enhancement System (“Stellaris”) and Stellaris PC (all Bausch + Lomb) includes 41 additional features and controls that collectively enhance the performance of the two systems and make them even easier to use.

Use of a femtosecond laser for capsulotomy and lens fragmentation can facilitate cataract surgery in eyes with a rock-hard cataract.

A new digital image guidance platform (Surgical Navigation System, Cirle) for cataract surgery is an open-source system designed to enhance accurate execution of cataract incision placement, capsulorhexis sizing and centration, toric IOL alignment, and limbal relaxing incision placement.

The approval of intracameral phenylephrine and ketorolac injection 1%/0.3% (Omidria, Omeros Corp.) could have implications for preoperative management and potentially postoperative management as well, according to John R. Wittpenn, MD, Ophthalmic Consultants of Long Island. While the FDA study evaluated pain and maintenance of pupillary dilation pertaining to intraoperative use of Omidria, the findings hint at additional benefits.

A physician who conducted cataract surgeries on 130 poor and elderly people at a health camp in the northern Indian state of Punjab has been arrested, according to the Associated Press.

Manufacturers of ophthalmic diagnostic systems are increasingly incorporating advances that improve the predictability of outcomes and integrate technologies.

In terms of medication use in cataract surgery, ophthalmologists discussed the continued increasing use of the intracameral route for antibiotic administration to prevent endophthalmitis and the launch of the “Go Dropless” campaign.

Innovations in femtosecond laser-assisted cataract surgery and microinvasive glaucoma surgery continue to drive the momentum of cataract procedures into 2015.

Features of a proprietary femtosecond laser system enable successful laser-assisted cataract surgery in eyes with a history of LASIK or other pre-existing corneal conditions. The addition of intraoperative aberrometry optimizes IOL power selection.

With a wide array of IOL options available to their foreign colleagues, U.S. ophthalmologists eagerly await the approval and availability of additional lenses.

Findings evaluating the incidence of posterior vitreous detachment on quality of vision and reading speed have been released.

Using the most recent nomogram for intrastromal astigmatic keratotomy using a proprietary femtosecond laser platform, the mean vector magnitude achieved was 87%.

Planning for the fifth year of “Cataract Surgery: Telling It Like It Is,” set for Thursday, Jan. 15, to Sunday, Jan. 18, is well under way and meeting organizer Robert H. Osher, MD, promises “more faculty, more topics, and a lot more fireworks” for this latest gathering here.

Patients who undergo second eye cataract surgery benefit with improvements in visual function and quality of life to levels beyond those obtained after first eye cataract surgery, said Nakul Shekhawat, MD.