SMILE for Myopic Astigmatism: Early Experience in the USA and International Advances
AbstractPurpose of ReviewIn this article, we review the early experience with small incision lenticule extraction (SMILE) in the USA as well as recent international data. We address long-term experience, new techniques, optimization of settings, corneal biomechanics, and comparison with other refractive surgical procedures.Recent FindingsDespite promising early experience, US refractive surgeons have adopted the SMILE procedure slowly, owing in part to limitations on energy settings that have impacted early visual recovery. Outside of the USA, advances in parameters and techniques have driven improved early and long-term o...
Source: Current Ophthalmology Reports - August 16, 2020 Category: Opthalmology Source Type: research
Incidence and Management of Cystoid Macular Edema after Corneal Transplantation
AbstractPurpose of ReviewIn this review, we overview the incidence and management of cystoid macular edema following endothelial keratoplasty (EK) including Descemet ’s stripping automated endothelial keratoplasty (DSAEK) and Descemet’s membrane endothelial keratoplasty (DMEK).Recent FindingsIncidence of CME was 2.0 –12.7% following DSAEK and 0.7–15.6% following DMEK. Glaucomatous eyes, in particular, with primary angle closure glaucoma and eyes with severe iris damage and eyes with combined EK with transscleral intraocular lens implantation experienced postoperative CME at a higher incidence. Topical non-s teroida...
Source: Current Ophthalmology Reports - August 5, 2020 Category: Opthalmology Source Type: research
Correction to: Effect of Intravitreal Injections on Retinal Imaging Metrics in Glaucomatous and Non-Glaucomatous Eyes
The original version of this article unfortunately contained a mistake. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - July 12, 2020 Category: Opthalmology Source Type: research
Retinal Tamponades: Current Uses and Future Technologies
AbstractPurpose of ReviewIn this article, the current use and limitations of existing retinal tamponades are discussed. Potential novel developments that address those limitations are subsequently highlighted, along with areas of future improvements.Recent FindingsWhile retinal tamponades have existed for decades and improved the treatment of retinal detachments, many problems still exist with their use, including inadequate tamponade of the inferior retina, toxicity from retained heavy liquids, glaucoma, and keratopathy, among others. New advancements in the components of heavy liquids and vitreous substitutes aim to miti...
Source: Current Ophthalmology Reports - July 3, 2020 Category: Opthalmology Source Type: research
Bioengineering of Human Corneal Endothelial Cells from Single- to Four-Dimensional Cultures
AbstractPurpose of ReviewTo summarize the recent advances of clinical and preclinical studies for corneal endothelial tissue bioengineering.Recent FindingsThe challenges facing the generation of a clinical applicable corneal endothelial graft can be broadly classified into cell source selection, culture medium optimization, scaffold establishment, and the following three- and four-dimensional (4D) corneal construction. Based on the current advances in primary human corneal endothelial cell (HCEC) culture and good manufacturing practice (GMP) –compliant medium development, the first clinical trial of bioengineered HCEC in...
Source: Current Ophthalmology Reports - June 29, 2020 Category: Opthalmology Source Type: research
The Impact of Glaucoma Drainage Devices on the Cornea
AbstractPurpose of ReviewTo discuss the relevant clinical associations between glaucoma drainage device (GDD) implantation and health of the cornea, focusing on corneal endothelial disease and success of viability of keratoplasty.Recent FindingsCorneal endothelial injury and risk of graft failure continues to demonstrate association with GDD placement; however, newer studies demonstrate improved outcomes associated with Descemet membrane endothelial keratoplasty. Additionally, newer adverse effects associated with GDD placement have been described.SummaryGDD implantation certainly carries risk of endothelial injury and ker...
Source: Current Ophthalmology Reports - June 25, 2020 Category: Opthalmology Source Type: research
Impact and Trends in Global Ophthalmology
AbstractPurpose of ReviewOur goal is to provide a review of the impact, global estimates, and projection of vision impairment as well as ongoing systems for eye care delivery.Recent FindingsMany of the blinding diseases in developing countries are preventable or curable, but the lack of ophthalmologists, the lack of education, and the lack of access to any eye care are some of the major obstacles encountered.SummaryAs our world becomes more interconnected through globalization, the interactions between different cultures and populations increase. Global ophthalmology is a field dedicated to building sustainable eye care de...
Source: Current Ophthalmology Reports - June 21, 2020 Category: Opthalmology Source Type: research
Presbyopia Correction at the Time of Cataract Surgery
AbstractPurpose of ReviewIn this article, we review the latest research related to presbyopia management at the time of cataract surgery with attention focused on available options in the USA.Recent FindingsWith refractive cataract surgery, patient satisfaction is largely dependent on preoperative expectations with regard to spectacle independence and photic phenomena. Monovision with monofocal intraocular lenses have the highest rates of spectacle dependence but the lowest rate of photic phenomena. Extended depth of focus lenses provides excellent distance and intermediate vision, but patients often require glasses for ne...
Source: Current Ophthalmology Reports - June 19, 2020 Category: Opthalmology Source Type: research
White Cataracts —Tips, Techniques and New Perspective
AbstractPurpose of ReviewThe main scope of this review will be directed toward relevant literature about white cataracts published in the last year that may be useful for daily practice. Significant studies published in previous years may also be cited. Traumatic or other uncommon etiology white cataract reports have not been included.Recent FindingsWhite cataract surgery is challenging in many ways, with capsulotomy being the main aspect of concern. Peripheral extension of capsulotomy is still a frequent concern that can further complicate the procedure and lead to a high incidence of posterior capsule rupture. Improvemen...
Source: Current Ophthalmology Reports - June 12, 2020 Category: Opthalmology Source Type: research
Diving Deep into Deep Learning: an Update on Artificial Intelligence in Retina
AbstractPurpose of ReviewIn the present article, we will provide an understanding and review of artificial intelligence in the subspecialty of retina and its potential applications within the specialty.Recent FindingsGiven the significant use of diagnostic imaging within the retina, this subspecialty is a fitting area for the incorporation of artificial intelligence. Researchers have aimed at creating models to assist in the diagnosis and management of retinal disease as well as in the prediction of disease course and treatment response. Most of this work thus far has focused on diabetic retinopathy, age-related macular de...
Source: Current Ophthalmology Reports - June 6, 2020 Category: Opthalmology Source Type: research
Optical Coherence Tomography: Critical Tool to Manage Expectations after Cataract Extraction
AbstractPurpose of ReviewTo review evidence on the utility of spectral domain optical coherence tomography (SD-OCT) in evaluating retinal structure prior cataract surgery and highlight new technologies that can assess retinal function perioperatively.Recent FindingsSD-OCT detected clinically unsuspected macular pathology in 4.6 –25% of individuals in the pre-operative cataract evaluation. The most common findings were epiretinal membrane and macular degeneration with frequencies that varied by population studied. These conditions have been associated with complication after surgery (e.g., macular edema, visual dissatisfa...
Source: Current Ophthalmology Reports - June 5, 2020 Category: Opthalmology Source Type: research
Corneal Cross-linking: Epi-On vs. Epi-Off Current Protocols, Pros, and Cons
AbstractPurpose of ReviewTo review the current protocols for corneal cross-linking for the treatment of keratoconus, including a comparison of epithelial off (Epi-off) and epithelial on (Epi-on) treatments.Recent FindingsAfter over 15 years of investigation, corneal cross-linking was approved in the USA in 2016. While Epi-off cross-linking is safe and effective, it is also associated with some drawbacks. Therefore, Epi-on is being investigated as a safer alternative. This paper reviews traditional Epi-off cross-linking and the latest Epi-on protocols.SummaryWhile Epi-on protocols are being evaluated and have shown potent...
Source: Current Ophthalmology Reports - June 3, 2020 Category: Opthalmology Source Type: research
Effect of Intravitreal Injections on Retinal Imaging Metrics in Glaucomatous and Non-Glaucomatous Eyes
AbstractPurpose of ReviewTo summarize the available literature on retinal imaging metrics in the context of intravitreal injections in glaucomatous and non-glaucomatous eyes.Recent FindingsThe retinal nerve fiber layer (RNFL) in injected non-glaucomatous eyes appears to thin at a similar rate to uninjected fellow eyes. A total of four studies evaluating RNFL thinning in injected glaucomatous eyes yielded mixed results, with more recent longitudinal investigations suggesting a potential association. The ganglion cell-inner plexiform layer is also being studied as a potential endpoint in both glaucomatous and non-glaucomatou...
Source: Current Ophthalmology Reports - June 3, 2020 Category: Opthalmology Source Type: research
Glaucoma and Pregnancy
This article is a review of studies relating to glaucoma in pregnancy. It also examines medical, laser, and surgical options specific to the particular needs of this population.Recent FindingsIn general, there is limited data on management of glaucoma in pregnancy, and no guidelines for treatment have been established. In one recent case series, pregnant women exposed to glaucoma medications were found to have no difference in pregnancy or fetal/neonatal outcomes compared with a control group. There are no available data for the use of the newer intraocular pressure (IOP) lowering agents (latanoprostene bunod, netarsudil) ...
Source: Current Ophthalmology Reports - June 3, 2020 Category: Opthalmology Source Type: research
Pros and Cons of Bilateral Immediately Sequential Cataract Surgery
AbstractPurpose of ReviewImmediately sequential bilateral cataract surgery (ISBCS) has been gaining attention over the past decade as a more efficient way to address the growing need for cataract removal in an aging population, and yet delayed sequential bilateral cataract surgery (DSBCS) remains the standard of care in many ophthalmologic communities. This review discusses some of the reasons surgeons have been hesitant to adopt ISBCS and hopes to address both the pros and cons of the procedure in the current medical environment.Recent FindingsMany of the current arguments against the practice of ISBCS involve potential b...
Source: Current Ophthalmology Reports - May 30, 2020 Category: Opthalmology Source Type: research
