Surgery

In a 24/7 world, the availability of the PureVision Toric Contact Lens (Bausch & Lomb) that incorporates an aspheric design is welcome news. The FDA approval in early April of the silicone hydrogel contact lens will offer patients who wear their lenses for long periods—even overnight—a healthy and more comfortable alternative to traditional hydroxyethylmethacrylate (HEMA) contact lenses.

Although trabeculectomy and deep sclerectomy provide long-term IOP reduction in patients with open-angle glaucoma, trabeculectomy is more effective than deep sclerectomy in achieving IOP less than or equal to 16 mm Hg with or without goniopuncture, reported Stefano A. Gandolfi, MD.

Bausch & Lomb's PureVision contact lenses are available in the United States once again, following the recent successful resolution of a patent dispute.

You can help influence the reimbursement level for specific CPT codes by participating in the Five-Year Review of Work Values, a comprehensive review of all physician relative work values conducted by the Centers for Medicare and Medicaid Services (CMS).

Better accommodating IOLs are also needed, and ideally, the new technology will be so sophisticated that it allows accommodation to be under the patient's control.

Washington, DC &#8212 Circular lamellar keratomileusis (CLK) is a new surgical procedure that offers a potentially safer alternative to LASIK for the treatment of low myopia (up to -5 D), myopic presbyopia, and emmetropic presbyopes, said Gholam Peyman, MD, at the Innovators Session.

Washington, DC &#8212 Nidek Inc. has received FDA marketing clearance for commercial release of its new MC-300 multicolor laser photocoagulator system. The company also announced that its new state-of-the-art YC-1800 ophthalmic YAG laser system is available for sale to the U.S. market.

Washington, DC &#8212 Clear lens replacement is considered a good option for patients who are well-educated about the risk factors pertaining to retinal detachment, explained J. Pitzer Gills III, MD, who spoke during a cataract/refractive symposium on refractive lens exchange, bioptics, and intracorneal lenses during the American Society of Cataract and Refractive Surgery annual meeting.

Austin, TX—Volume loss is an important aspect of post-enucleation socket syndrome (PESS), resulting from the inability of the prosthetic orbital implant to replace all of the volume lost from an enucleated or eviscerated socket. Fortunately, there are a number of effective techniques for volume augmentation in PESS, said John Shore, MD, FACS, who is in practice with Texas Oculoplastic Consultants, Austin, TX.

Contrast sensitivity testing has long been a technology that clinicians know has value, but the interpretation and implementation of the results were not clear. A number of recent scientific publications and new FDA standards have paved the way for contrast sensitivity to be more easily incorporated into routine clinical practice. This article traces the background of contrast sensitivity testing and some of the exciting developments related to its use in FDA clinical trials, for the management of "quality of vision," and for the monitoring and treatment of disease.

New Orleans—Silicone hydrogel contact lenses may produce fewer complications for patients because of their high oxygen permeability, although their extended wearability could negate that advantage, suggested Peter R. Kastl, MD, PhD, professor of ophthalmology and adjunct professor of biochemistry, Tulane University, New Orleans.

Baltimore—Fluocinolone acetonide intravitreal implant (Retisert, Bausch & Lomb) is an effective treatment for non-infectious posterior uveitis, but may have potential side effects, according to the interim results of a multicenter trial that Quan Dong Nguyen, MD, MSc, described during the Current Concepts in Ophthalmology meeting.

The insertion of larger orbital balls placed more posteriorly reduced the number of subsequent procedures.

Salt Lake City—A few cases of dystrophic calcification have been reported that required explantation of the patients' silicone IOLs because of the opacified posterior surface of the IOLs. The phenomenon seems to be associated with asteroid hyalosis, according to Liliana Werner, MD, PhD.

Mainz, Germany—The first clinical results from the European Multicenter Trial of the Artiflex foldable iris-claw phakic IOL (Ophtec, Groningen, the Netherlands) indicated that the implant is safe and effective for treating myopia after a 6-month follow-up period.

Atlanta—Up-to-date results from participants in the FDA clinical trial of the recently approved Verisyse phakic myopic IOL (Advanced Medical Optics) demonstrate that implant provides excellent refractive outcomes with a good safety profile, according to R. Doyle Stulting, MD, PhD.

The endothelial cell count had to be at least 2,500 cells/mm2 if the patient was over 45 years.

Accommodation ranged from 0.75to 2 D and did not change significantly throughout thefollow-up period.

New Orleans—The modified prolate anterior surface IOL (Tecnis, AMO) is creating a new standard for visual performance after cataract surgery, according to Robert M. Kershner, MD, MS, FACS, at the Spotlight on Cataracts 2004: Cataract Controversies Symposium, held during the joint meeting of the American Academy of Ophthalmology and European Society of Ophthalmology.

The lens is unique in that it is designed to change its true power during accommodation rather than changing its position in the eye.

Brookville, PA—The new aberration-free aspheric IOL (SofPort Advanced Optics, Bausch & Lomb) is an exciting advance in implant technology because of its potential to offer better quality of vision to all patients, said Louis D. "Skip" Nichamin, MD.

Chicago—Although the introduction of aphakic IOLs led to a 50-year epidemic of pseudophakic corneal edema, it is unlikely that the advent of phakic IOLs will cause history to repeat itself, said Joel Sugar, MD.

New Orleans—Patients undergoing intraocular refractive surgery with either refractive lens exchange (RLE) or phakic intraocular lens implantation need to be informed that there is a lifelong risk of retinal detachment, said Kirk H. Packo, MD, at the refractive surgery subspecialty day at the American Academy of Ophthalmology annual meeting.

New Orleans—Late-onset bleb leakage needs to be controlled to avoid such complications as blebitis or bleb-related endophthalmitis, which can result in poor visual outcome, reported Philip P. Chen, MD, during the glaucoma subspecialty day meeting at the American Academy of Ophthalmology annual meeting.

New Orleans—Patients with refractory glaucoma may be candidates for transscleral or endoscopic cyclophotocoagulation (CPC) to lower IOP (Figure 1), although there is no direct evidence comparing the two approaches, explained Neeru Gupta, MD, PhD.

New Orleans—Bleb needling may be a good approach for early bleb failure if medication, digital massage, and suture lysis or removal are not effective. In the case of late bleb failure, YAG laser lysis of the sclerotomy, bleb needling, and bleb revision are favored, according to glaucoma specialist Jon M. Ruderman, MD.

Nuremberg, Germany—The latest refinements in the Dodick laser photolysis system (A.R.C. Laser GmbH)—a new handpiece design, shorter pulse laser, and power VAC tubing system and improved laser hardware—have resulted in what investigators believe is a procedure that is superior to conventional ultrasound phacoemulsification.

Atlanta—CIBA Vision is hoping to attract new patients with a variety of programs, including a rebate and Super Bowl advertising.

Atlanta—CIBA Vision is hoping to attract new patients with a variety of programs, including a rebate and Super Bowl advertising.

Feds Raid Clinic in Botox Investigation" reported the headline in The Miami Herald (Dec. 2, 2004). "Four victims hospitalized after injection with Botox anti-wrinkle medicine! Details at 11," reported the local news anchor.