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june images

Seeing may be believing, but in the world of eye care,ophthalmologists have for years relied on charts andthree-dimensional (3-D) models in an attempt to explain conceptsthat are rather hard for patients to visualize.

San Francisco-Inferior placement of a single intrastromalcorneal ring segment (Intacs, Addition Technology) appears toafford better outcomes than double-segment placement when treatingkeratoconus and ectasia in eyes with peripheral (paracentral)cones, said Colin C.K. Chan, MD, at the annual meeting of theAmerican Society of Cataract and Refractive Surgery.

The Centers for Medicare and Medicaid Services (CMS) added the AcrySof IQ IOL (Alcon Laboratories) to the New Technology Intraocular Lens (NTIOL) classification of Reduced Spherical Aberration. Effective May 19, ambulatory surgery centers using the AcrySof IQ IOL for cataract surgery will receive an additional $50 from Medicare. The IOL gained inclusion by proving the same or greater clinical benefit as the lens that established the NTIOL subset. The NTIOL subset and adjusted payment will remain in effect until Feb. 27, 2011.

Advances in instrumentation also produced superior light probeswith improved illumination angles and the amount of illumination.

San Francisco-Significant progress has been made in theability to predict progression from ocular hypertension toglaucoma, but the same cannot be said for predicting whetherpatients with detectable disease will have progression to severevisual impairment or blindness, said Kuldev Singh, MD, MPH, atASCRS Glaucoma Day 2006.

S?o Paulo, Brazil Brazil-Deep sclerectomy is not the "holygrail" of glaucoma surgery, but available evidence indicates thatit is definitively safer than trabeculectomy, according to Tarek M.Shaarawy, MD. Deep sclerectomy can also result in long-term successrates comparable with those of trabeculectomy when performed withproper technique by experienced hands, he added.

The likelihood of detecting change increases as the frequency offollow-up imaging increases.

Seeing may be believing, but in the world of eye care,ophthalmologists have for years relied on charts andthree-dimensional (3-D) models in an attempt to explain conceptsthat are rather hard for patients to visualize.

San Francisco-The crystalens accommodating IOL (eyeonics)improved visual outcomes "dramatically" in a study of patients withhigh myopia or high hyperopia. The IOL achieved similar near visualacuity levels in both patient groups, reported Harvey Carter, MD,at the annual meeting of the American Society of Cataract andRefractive Surgery.

San Francisco-The new LADAR 6000 excimer laser (AlconLaboratories) is a technologically advanced system with numeroushardware and software improvements that together should furtheroptimize clinical outcomes of laser vision correction, said StephenF. Brint, MD, at the annual meeting of the American Society ofCataract and Refractive Surgery.

Overall, acute endothelial cell loss rates were about 6% for boththe central and peripheral cornea.

San Francisco-A study of the repeatability and accuracy ofthe iris registration capture function in the VISX STAR excimerlaser (Advanced Medical Optics [AMO]) indicated that there islittle variability in the measurement of the rotational change andpupil centroid shift between consecutive iris registrationcaptures. There is, however, significant variability of themeasurements in different eyes. Iris registration technology allowsfor a more precise alignment and placement of wavefront treatment,Louis Probst, MD, reported at the annual meeting of the AmericanSociety of Cataract and Refractive Surgery.

San Francisco-Initial experience with a small-diameter,intracorneal lens (PresbyLens, ReVision Optics) suggests it is asafe and effective method for treating presbyopia and that itoffers the potential to expand the LASIK market, said Arturo S.Chayet, MD, at the annual meeting of the American Society ofCataract and Refractive Surgery.

San Francisco-A comparison of wavefront-guided andwavefront-optimized treatments performed using the WaveLightAllegretto laser (WaveLight Laser Technologie AG) and the IntraLasefemtosecond laser system (IntraLase Corp.) indicates excellentrefractive predictability and visual outcomes can be obtained usingboth treatments, Karl G. Stonecipher, MD, reported at the annualmeeting of the American Society of Cataract and Refractive Surgery.

San Francisco-Although approved for initial hyperopic andpresbyopic correction, conductive keratoplasty (CK, Refractec) isan excellent tool for enhancement in cases of residual refractiveerror after myopic or hyperopic LASIK and in cases of patientsrequiring better near vision correction after crystalens (eyeonics)implantation, according to G. Peyton Neatrour, MD, who spoke aboutCK enhancement during the American Society of Cataract andRefractive Surgery annual meeting.

San Francisco-Patients who had severe night-visiondisturbances after refractive surgery found relief after undergoingtopography-wavefront-supported custom ablations to treat either asmall optical zone, previous decentered ablations, or irregularsurfaces, explained Dan Z. Reinstein, MD, MA(Cantab), FRCSC.

San Francisco-Outcomes from one surgeon's initial experiencewith use of the iris-claw phakic refractive IOL (Verisyse, AdvancedMedical Optics) suggest it is an acceptable choice for treatinghigh myopia, said Richard M. Awdeh, MD, at the American Society ofCataract and Refractive Surgery annual meeting.

San Francisco-The Synchrony Dual Optic Accommodating IOL(Visiogen) provides good functional vision, that is, a full rangeof visual acuity, in the patients who have had the lens implanted,according to Ivan Ossma-Gomez, MD, who reported on the lens'performance at the American Society of Cataract and RefractiveSurgery annual meeting.

San Francisco-Blended vision with diffractive and refractivemultifocal IOLs offers better visual results in all lightingconditions than bilateral diffractive multifocal technology,explained Henry L. Milne, MD, at the American Society of Cataractand Refractive Surgery annual meeting.

San Francisco-Higher-order aberration interactions can occurwith customized ablations, regardless of the laser platform. Withthe development of a new nomogram, University of Rochesterresearchers have been able to neutralize these interactions,providing more predictable visual outcomes, explained Scott M.MacRae, MD, during the American Society of Cataract and RefractiveSurgery annual meeting.

San Francisco-Inferior placement of a single intrastromalcorneal ring segment (Intacs, Addition Technology) appears toafford better outcomes than double-segment placement when treatingkeratoconus and ectasia in eyes with peripheral (paracentral)cones, said Colin C.K. Chan, MD, at the annual meeting of theAmerican Society of Cataract and Refractive Surgery.

The wave of the future is the truly accommodating IOL, that is, one that changes power and not position in the eye; these should have fewer ocular side effects compared with multifocal IOLs.

Cleveland-Twenty-three sites will collect data for anationwide study on the genetics of Fuchs' endothelial cornealdystrophy (FECD), which afflicts about 1% of the generalpopulation.

San Francisco-Topography detects the early curvature changeson the anterior corneal surface. And these are precisely thechanges that need to be heeded in patients undergoing refractivesurgery. These changes may have been ignored previously andresulted in the development of vision-threatening ectasia, reportedStephen D. Klyce, PhD, who spoke at the annual meeting of theAmerican Society of Cataract and Refractive Surgery.

The Fusarium keratitis outbreak might have been spotted sooner hadthere been better communication between the country's ophthalmicmicrobiology centers, according to a couple of ophthalmologists.

Miami-In uveitis cases, laboratory testing often fails because of the low prevalence of the types of uveitis diagnosable by this means.

Compulsive graft management, questions, appropriate differentialdiagnosis are key, surgeon says

As investigators search for the source of an unusual outbreak of Fusarium keratitis cases among contact lens wearers, the number of confirmed cases continues to climb.

Baltimore-Divergence and convergence abnormalities are similar in nature and can be difficult to differentiate. Michael Repka, MD, described the subtleties as well as what works best for these patients.