Surgery

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Rochester, NY?The FDA has cleared additional labeling claims for Bausch & Lomb's ReNu with MoistureLoc Multi-Purpose Solution (MPS). The FDA cleared labeling that includes a specific indication for ReNu with MoistureLoc solution use with silicone hydrogel contact lenses, and an additional claim that the product conditions contact lenses, in support of its original "sustained comfort" labeling claim.

FDA approval of the crystalens (eyeonics), in addition to the AcrySof ReSTOR (Alcon Laboratories) and ReZoom multifocal (AMO) IOLs, allows ophthalmologists the ability to offer various choices of presbyopia-correcting technology with the hope of providing a surgical procedure that will greatly reduce or eliminate their patients' dependence on glasses following cataract surgery and refractive lens exchange. Hype and rumor regarding accommodating lens technology has created confusion regarding just how effective or ineffective these particular lenses may be. A review of the results in peer-reviewed medical literature in addition to an analysis of theoretical considerations with regard to the limits of accommodation provided by these lenses should clarify their ultimate usefulness in the average ophthalmic practice.

Chicago?Cataract and glaucoma can occur in eyes with phakic IOLs, but the risk of those complications can often be minimized by careful surgical technique and IOL sizing, said Antonio Marinho, MD, PhD, at the refractive surgery subspecialty day meeting sponsored by the International Society of Refractive Surgery of the American Academy of Ophthalmology.

Chicago—The foldable version of the iris claw fixated myopic phakic IOL (Artiflex II/Veriflex, Ophtec/AMO) affords faster recovery of excellent uncorrected visual acuity (UCVA) compared with the polymethylmethacrylate (PMMA) model (Artisan/Verisyse, Ophtec, AMO), but otherwise has the same favorable efficacy and safety profile associated with its widely used predecessor, according to results of a prospective, intrapatient comparison study reported by Jose L. Guell, MD, PhD, at the subspecialty day meeting sponsored by the International Society of Refractive Surgery of the American Academy of Ophthalmology.

Chicago—IntraLASIK as a one-step procedure using the femtosecond laser microkeratome (IntraLase) for flap creation shows promise as a safe and effective approach for correcting ametropia after penetrating keratoplasty (PK), although the best refractive results may be achieved in eyes with only mild to moderate astigmatism, said Irina S. Barequet, MD, at the refractive surgery subspecialty day meeting sponsored by the International Society of Refractive Surgery of the American Academy of Ophthalmology.

Lisbon, Portugal—Accurate adjustment of the new Light Adjustable Intraocular Lens (LAL) (Calhoun Vision) after implantation is possible using new digital light delivery systems and may eliminate the need for explantation of the IOL because of incorrect lens power after cataract surgery, reported Nick Mamalis, MD, at the annual meeting of the European Society of Cataract and Refractive Surgeons.

Baltimore—Extensive research has already led to the identification of a number of surgery- and IOL-related factors that can be targeted to reduce the occurrence of posterior capsule opacification (PCO). Investigators are continuing to evaluate new strategies to reduce its risk further in the future, said Albert S. Jun, MD, PhD, at Current Concepts in Ophthalmology, Baltimore.

Advanced Medical Optics (AMO) Inc.'s Tecnis foldable IOL has earned the title of New Technology IOL (NTIOL) from the Centers for Medicare and Medicaid Services (CMS). The designation follows labeling claims approved by the FDA in April 2004 that the lens reduced postoperative spherical aberrations compared with lenses with spherical optics and improved night driving simulator performance. The designation was effective Feb. 27.

Chicago-The future of presbyopic lens exchange for high myopia looks bright with the development of various IOL options, according to one proponent. Yet, surgeons and patients should be aware of possible complications, such as retinal detachment, and seek alternatives, cautions another refractive surgeon.

Glaucoma implants may fail for a number of reasons, said Felix Gil Carrasco, MD, at the World Congress of Ophthalmology on Wednesday. However, inappropriate patient selection and improper placement of the shunt are probably the most common reasons.

Deep sclerectomy is not the holy grail of glaucoma surgery, but available evidence indicates that it is definitively safer than trabeculectomy and that it can result in long-term success rates matching those of trabeculectomy when performed with proper technique by experienced hands, said Tarek M. Shaarawy, MD, at the World Ophthalmology Congress.

More than 15,000 ophthalmologists from more than 110 countries are registered to attend, and more than 4,000 scientific papers were submitted for consideration. The schedule features more than 400 sessions in addition to subspecialty days, with some 2,400 speakers from all regions of the world.

Miami—Results from an international clinical trial including nearly 1,600 eyes indicate laser presbyopia reversal (LAPR) increases accommodation and improves near and intermediate vision with a benefit that is maintained for up to 5 years, said Richard S. Kalski, MD.

Chicago—Implantation of microthin prescription inserts (Intacs, Addition Technology) for the treatment of keratoconus appears to result in better visual outcomes when the femtosecond laser (IntraLase FS, IntraLase) is used for channel creation instead of a mechanical device, said Yaron S. Rabinowitz, MD. He spoke during the refractive surgery subspecialty day meeting sponsored by the International Society of Refractive Surgery of the American Academy of Ophthalmology.

Elmira, NY—An ambulatory surgery center (ASC) here has won an "Innovations in Quality Improvement Award" from the Accreditation Association for Ambulatory Health Care (AAAHC)'s Institute for Quality Improvement.

Cincinnati—Robert H. Osher, MD, professor of ophthalmology at the University of Cincinnati and medical director emeritus of the Cincinnati Eye Institute, is celebrating 20 years of the Video Journal of Cataract and Refractive Surgery with two issues in 2006.

Chicago—Results of a study including more than 1,000 eyes followed for up to 3 years show that selective laser trabeculoplasty (SLT) performed with the Q-switched frequency-doubled 532-nm Nd:YAG laser (Selecta II, Lumenis) is a safe and effective option for lowering and maintaining IOP across a spectrum of glaucoma patients, reported Lawrence F. Jindra, MD, at the annual meeting of the American Academy of Ophthalmology.

In the continual quest for a better understanding of vision, the Wilmer Eye Institute at Johns Hopkins University School of Medicine, Baltimore, is presenting its annual Current Concepts in Ophthalmology series.

Rogers, AR—The recent approval of the Tecnis IOL (AMO) on an acrylic platform gives cataract surgeons another option in an expanding menu of choices, said Randy Cole, MD, FACS, who is medical director and founder of Boozman-Hof Eye Surgery and Laser Center, Rogers, AR.

Vienna, Austria—A sharp posterior optic edge design seems to be superior to a double round optic edge design in preventing posterior capsule opacification (PCO). Investigators reported significantly less PCO at 1, 2, and 3 years after implantation of the Sensar OptiEdge AR40e IOL compared with the Sensar AR40 model (both from AMO).

The development of IOLs has come full circle. In 1949, Sir Harold Ridley attempted to emulate the curvature and size of the natural lens with the development of the Ridley IOL. In subsequent years, the focus was on IOL mechanical issues, materials, and optics. Today, with wavefront technology, researchers are going back to the beginning and are attempting to emulate some of the more subtle features of the natural lens.

Lisbon, Portugal—The results of the 7th annual survey on foldable IOLs indicate that dislocation and decentration are the most common reasons for lens explantation, with incorrect lens power the next most important factor.