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Anticlotting agents and the surgical management of glaucoma
Purpose of review A large subset of patients with glaucoma uses anticlotting agents. No standardized guidelines currently exist for managing these agents in the specific perioperative setting of glaucoma surgery. The present review focuses on currently available anticlotting agents, their influence on hemorrhagic complications following glaucoma surgery, and management strategies for their use in the perioperative period Recent findings Anticlotting agents increase the risk of perioperative hemorrhagic complications following glaucoma surgery. Other factors that increase that risk have been identified as well, includi...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Descemet membrane endothelial keratoplasty and glaucoma
Purpose of review The aim of this review is to describe the relationship between Descemet membrane endothelial keratoplasty (DMEK) and glaucoma. Recent findings Glaucoma after DMEK is a serious complication that may cause permanent visual loss, affect donor endothelial cells and graft survival. The mechanisms of raised intraocular pressure (IOP) after DMEK include reverse pupillary block in the early postoperative period, and steroid response in the late phase. The reduced risk of immunogenic graft rejection after DMEK necessitates a shorter duration of steroids, which may in turn reduce the risk of steroid response. ...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Drop instillation and glaucoma
Purpose of review To describe the current state of knowledge regarding glaucoma patients’ eye drop technique, interventions attempting to improve eye drop technique, and methods for assessing eye drop technique. Recent findings In observational studies, between 18.2 and 80% of patients contaminate their eye drop bottle by touching their eye or face, 11.3–60.6% do not instill exactly one drop, and 6.8–37.3% miss the eye with the drop. Factors significantly associated with poorer technique include older age, lack of instruction on eye drop technique, female sex, arthritis, more severe visual field defe...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Review of the Xen Gel Stent and InnFocus MicroShunt
Purpose of review Two new translimbal glaucoma devices (Xen Gel Stent and InnFocus MicroShunt) have been developed with the goal of optimizing the predictability and safety for subconjunctival glaucoma surgery. Recent findings The new subconjunctival glaucoma implants are manufactured from nonsilicone, biocompatible materials, which may reduce the postoperative inflammatory and fibrotic reactions that can lead to failure. Early data suggests a favorable safety profile with significant reductions in intraocular pressure (IOP). The prevention of chronic hypotony has been a hallmark of the devices, which utilize an intri...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Suprachoroidal shunts
This article reviews recent studies evaluating the efficacy and safety of ab externo and ab interno suprachoroidal shunts designed to augment uveoscleral outflow in patients with open angle glaucoma. Recent findings The Gold Shunt and STARflo are placed into the suprachoroidal space via an ab externo approach, while the CyPass Micro-Stent and iStent Supra are inserted ab interno through a clear corneal incision. A small randomized clinical trial suggested similar efficacy among two different models of the Gold Shunt and the Ahmed glaucoma valve. The pivotal multicenter, randomized COMPASS trial showed that the CyPass Mi...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Complications of micro-invasive glaucoma surgery
Purpose of review Micro-invasive glaucoma surgery (MIGS) is gaining favor with both comprehensive ophthalmologists and glaucoma specialists due in part to its improved safety profile when compared to traditional incisional glaucoma surgery. Despite a micro-invasive approach and minimal induced tissue trauma, each MIGS procedure is associated with unique complications. The present article summarizes evidence from the 2016 to 2017 review period regarding the safety profiles of Schlemm's canal-based, suprachoroidal, and subconjunctival microstents. Recent findings Ab-interno microstents are subject to intraoperative malp...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Recent developments in visual field testing for glaucoma
Purpose of review Visual field testing remains one of the most important tools for characterizing and monitoring vision loss in glaucoma. Despite its current mainstream use, new developments continue to emerge on its current use and potentially better methods for its testing and analysis. This review summarizes new developments in visual field testing and, in particular, standard automated perimetry. Recent findings Evidence-based guidance has recently been provided on the impact of testing frequency on the ability to detect visual field progression. An increasing body of evidence also highlights numerous factors that...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Glaucoma and quality of life: fall and driving risk
Purpose of review Numerous population-based studies suggest that glaucoma is an independent risk factor for falling and motor vehicle collisions, particularly for older adults. These adverse events lead to increased healthcare expenditures and decreased quality of life. Current research priorities, therefore, include identifying factors that predispose glaucoma patients to falling and unsafe driving, and developing screening strategies and targeted rehabilitation. The purpose of this article is to review recent studies that address these priorities. Recent findings Studies continue to support that glaucoma patients, p...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Changing patterns in treatment of angle closure glaucoma
Purpose of review Angle closure glaucoma is a leading cause of blindness globally and trends of how best to treat this disease are evolving. The advent of anterior segment imaging aids our understanding of pathogenesis and allows more robust and objective measurement of treatment modalities. We will also review recent literature regarding the role of laser and surgical interventions for the treatment of primary angle closure disease. Recent findings Recent studies evaluating the efficacy of laser peripheral iridotomy (LPI) in primary angle closure suspects (PACs) show that while it is a safe intervention and initially...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

New developments in optical coherence tomography imaging for glaucoma
Purpose of review Since its introduction in ophthalmology, optical coherence tomography (OCT) has undergone significant advances in imaging protocols, algorithms, and addition of new parameters which have maximized its potential for diagnosing, evaluating the response to treatment, and assessing the progression of various ocular diseases, including glaucoma. This review provides an update on recent developments in OCT with respect to the management of glaucoma. Recent findings Most recent notable developments include the introduction of the minimum distance band, which is a three-dimensional optic nerve head parameter...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Ginkgo biloba and its potential role in glaucoma
This study will review the research on the effect of ginkgo biloba extract (GBE) on patients with glaucoma. Recent findings GBE appears to increase ocular blood flow in those with glaucoma. However, data on visual field outcomes are inconclusive. Summary GBE has been shown to have antioxidant and vascular effects, making it potentially effective in treating glaucoma. Published data are limited but show an increase in ocular blood flow after GBE administration. Conclusive evidence is lacking regarding the effect of GBE on clinical outcomes in glaucoma patients such as visual field performance. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Twenty-four hour intraocular pressure measurements and home tonometry
Purpose of review IOP is the only treatable risk factor contributing to glaucoma and most management and treatment of glaucoma is based on IOP. However, current IOP measurements are limited to office hours and control of glaucoma in many patients would benefit from the ability to monitor IOP diurnally so as not to miss abnormal pressures, which occur outside of office hours Consequently, to improve patient care, the ability to enable accurate and minimally disruptive diurnal IOP monitoring would improve caring for these patients. Recent findings The studies we selected for this review can be divided into three categor...
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Editorial introduction
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - February 8, 2018 Category: Opthalmology Tags: Editorial Introduction Source Type: research

Minimally invasive brow lifting techniques: erratum
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: Erratum Source Type: research

The role of small incision suture-less cataract surgery in the developed world
Purpose of review Manual small incision cataract surgery (MSICS) has recently gone through much refinement and fine tuning. It is often taken as an alternate option for phacoemulsification, especially in developing country. This review will present some insight on its applications especially for developed nations. The role of MSCIS in tackling complex cataracts with stony hard nucleus is fairly established. The role of training residents with MSCIS has certain advantages though debatable. Recent findings MSCIS is much faster and cost-effective surgical technique often possible in suboptimal condition and avoids the ca...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Measuring outcomes in cataract surgery
Purpose of review The article presents a review of recently published studies reporting postcataract surgery outcomes and the use of electronic systems to track them. Recent findings Current publications report several parameters to measure cataract outcomes such as visual acuity, patient-reported visual function, contrast sensitivity, reading speed, residual refractive errors and complications (intraoperative and postoperative). Summary Cataracts currently afflict an estimated 94 million people worldwide, and surgical removal is the only effective therapy known. Tracking outcomes through registry databases has bee...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Role of lens extraction and laser peripheral iridotomy in treatment of glaucoma
Purpose of review Lens extraction in people with coexisting cataract and open angle glaucoma is associated with a reduction in intraocular pressure (IOP). In primary angle-closure glaucoma (PACG), lens extraction and laser peripheral iridotomy (LPI) can be used to open the anterior chamber angle, increase the outflow through the trabecular meshwork and reduce the IOP. The present review will summarize the recent available literature regarding the role of both interventions for the treatment of glaucoma. Recent findings Recent articles have confirmed the effect of cataract surgery as an IOP-lowering procedure in people...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Co-management of cataract and glaucoma in the era of minimally invasive glaucoma surgery
We present a strategy for planning which surgery should be performed based on goals of care. Recent findings New clinical evidence for using the CyPass, Kahook and Xen45 devices has been published recently and is summarized. Summary Cataract and glaucoma frequently exist together. Because the field of glaucoma surgical care is expanding and cataract surgery is becoming progressively safer, it is important to frequently re-evaluate our treatment paradigms. We review and evaluate current studies and treatment options. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Cataract surgery in ocular surface diseases: clinical challenges and outcomes
This article discusses the challenges and outcomes of cataract surgery in complex cases targeting eyes with ocular surface diseases like Stevens–Johnson syndrome, ocular cicatricial pemphigoid, Mooren's ulcer, vernal keratoconjunctivitis and limbal stem cell deficiency. Recent findings Ocular surface diseases are commonly associated with corneal scarring and vascularization, conjunctival inflammation, symblepharon and forniceal shortening. Any surgical intervention in a hostile ocular surface environment may worsen the disease, which may result in visual deterioration. In recent past, with the use of immunosuppres...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Cataract surgery in eyes with keratoconus: a review of the current literature
Purpose of review There are an increasing number of keratoconic eyes, requiring cataract surgery. We review the preoperative planning, intraoperative options, and postoperative management that aid in successful outcomes. Recent findings Management of keratoconic eyes requiring cataract surgery requires a multifaceted approach. Preoperatively, corneal crosslinking and intrastromal corneal ring segments can be considered in order to provide stable keratometry values for intraocular lens (IOL) calculations. Deciding between toric and monofocal IOLs requires a thorough evaluation. Intraoperatively, the decision of clear c...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Management of cataract in uveitis patients
Purpose of review This review is timely because the outcomes of surgical invention in uveitic eyes with cataract can be optimized with adherence to strict anti-inflammatory principles. Recent findings All eyes should be free of any cell/ flare for a minimum of 3 months preoperatively. Another helpful maneuver is to place dexamethasone in the infusion fluid or triamcinolone intracamerally at the end of surgery. Recent reports about the choice of intraocular lens material or lens design are germane to the best surgical outcome. Integrating these findings will promote better visual outcomes and allow advancement in resea...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Dysphotopsia: a multifaceted optic phenomenon
Purpose of review To summarize the literature on dysphotopsia, focusing on strategies for management and prevention. Recent findings Clinical studies and ray-tracing diagrams have improved our understanding of the risk factors for positive and negative dysphotopsiae. Well known management and prevention strategies such as piggyback IOL, reverse optic capture, Nd:YAG capsulotomy, and IOL exchange are reviewed, as well as newer strategies such as the infertemporal approach to IOL implantation, ‘in-the-bag nasal optic truncation’ and new IOL design implantation, and new IOL design. Summary Positive and neg...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Femtosecond laser-assisted versus phacoemulsification for cataract extraction and intraocular lens implantation: clinical outcomes review
Purpose of review Femtosecond laser-assisted cataract surgery (FLACS) has gained popularity in recent years with the new technology suggesting potential improvements in clinical and safety outcomes over conventional phacoemulsification cataract surgery (PCS). A decade since the advent of FLACS has given time and experience for laser technology to develop in maturity, and better quality evidence to become available. This review evaluates current evidence on the clinical and safety outcomes for FLACS in comparison to PCS. Recent findings FLACS technology continues to improve and with it our confidence in tackling more c...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Prevention of macular edema after cataract surgery
Purpose of review Although cataract surgery can effectively restore visual function in many patients with cataract, PCME remains an important cause of suboptimal visual acuity. The present review provides an overview of the current literature on the prevention and treatment of PCME. Recent findings Optimal prevention of PCME starts preoperatively with a personalized risk assessment. Diabetes mellitus, retinal vein occlusion, epiretinal membrane, macular hole, and uveitis are the most important risk factors for developing cystoid macular edema after cataract surgery. Topical NSAIDs either in addition to, or instead of,...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Recent advances in small pupil cataract surgery
Purpose of review To highlight the existing and emerging cataract surgery trends in patients with insufficient mydriasis. Discuss the latest pharmacological approaches for pre and intraoperative pupil dilatation. Present the variety of newest pupil expansion devices; critically review their advantages and possible limitations to be considered by the surgeon. Recent findings The intracameral use of various mydriatic combinations augmenting the preoperative mydriatic instillations is currently gaining popularity in cataract surgery. Two main options are available: bolus injection of pharmacological agent or its constant...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Intracameral antibiotics during cataract surgery: evidence and barriers
Purpose of review There is continuing debate regarding the safety, efficacy, and necessity of intracameral antibiotics to prevent postoperative endophthalmitis. We summarize the most recent evidence-based publications that either support or caution against this practice. Recent findings Several additional large, international retrospective clinical studies found a significant reduction in endophthalmitis rates with intracameral antibiotic prophylaxis. Many surgeons are looking for alternatives to vancomycin for intracameral prophylaxis because of its association with the rare but sight-threatening complication of hemo...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

The use of povidone–iodine in ophthalmology
Purpose of review Povidone–iodine (PVI) is a disinfectant and antiseptic agent used for preoperative preparation of the skin and mucous membranes, as well as for the treatment of contaminated wounds. Currently regimens for prophylaxis against postsurgical endophthalmitis are being modified, including a total withdrawal of antibiotics in intravitreal injections. The aim of this study was to evaluate the use of PVI in ophthalmology. Recent findings As a result of its broad spectrum of microbicidal activity, PVI is routinely used in ophthalmic surgery. However, various protocols are applied worldwide and within dif...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Wound closure and tissue adhesives in clear corneal incision cataract surgery
Purpose of review Achieving secure wound closure in clear corneal incision cataract surgery remains highly desired for its role in reducing infection risk and leak-related complications, including hypotony, corneal edema, and lens dislocation. Although classic techniques of stromal hydration or wound suturing represent traditional approaches, the introduction of newer and more effective ocular surface adhesives has increased the options that are available. This review aims to provide an update on the peer-reviewed literature regarding wound closure and the currently available and investigational tissue adhesives used to ...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Astigmatism evaluation prior to cataract surgery
Purpose of review To evaluate and summarize literature from the past 18 months reporting advancements and issues in astigmatism assessment prior to cataract surgery. Recent findings New and updated toric calculators and regression formulas offer the opportunity for more accurate lens selection for our patients. Concurrently, improvements in topographic evaluation of corneal keratometry have allowed for a decrease in unplanned residual corneal astigmatism. Measuring posterior corneal astigmatism is especially valuable in eyes with keratoconus when planning to implant toric intraocular lens (IOL) and now allows access t...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Evaluation of the macula prior to cataract surgery
Purpose of review To describe recent evidence regarding methods of evaluation of retinal structure and function prior to cataract surgery. Recent findings Studies in patients with cataract but no clinically detectable retinal disease have shown that routine use of optical coherence tomography (OCT) prior to cataract surgery can detect subtle macular disease, which may alter the course of treatment or lead to modification of consent. The routine use of OCT has been especially useful in patients being considered for advanced-technology intraocular lenses (IOLs) as subtle macular disease can be a contraindication to the ...
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Advances in cataract surgery in patients with multiple ocular diagnoses
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - January 1, 2018 Category: Opthalmology Tags: Editorial Introductions Source Type: research

Minimally invasive brow lifting techniques: erratum
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: Erratum Source Type: research

The role of small incision suture-less cataract surgery in the developed world
Purpose of review Manual small incision cataract surgery (MSICS) has recently gone through much refinement and fine tuning. It is often taken as an alternate option for phacoemulsification, especially in developing country. This review will present some insight on its applications especially for developed nations. The role of MSCIS in tackling complex cataracts with stony hard nucleus is fairly established. The role of training residents with MSCIS has certain advantages though debatable. Recent findings MSCIS is much faster and cost-effective surgical technique often possible in suboptimal condition and avoids the ca...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Measuring outcomes in cataract surgery
Purpose of review The article presents a review of recently published studies reporting postcataract surgery outcomes and the use of electronic systems to track them. Recent findings Current publications report several parameters to measure cataract outcomes such as visual acuity, patient-reported visual function, contrast sensitivity, reading speed, residual refractive errors and complications (intraoperative and postoperative). Summary Cataracts currently afflict an estimated 94 million people worldwide, and surgical removal is the only effective therapy known. Tracking outcomes through registry databases has bee...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Role of lens extraction and laser peripheral iridotomy in treatment of glaucoma
Purpose of review Lens extraction in people with coexisting cataract and open angle glaucoma is associated with a reduction in intraocular pressure (IOP). In primary angle-closure glaucoma (PACG), lens extraction and laser peripheral iridotomy (LPI) can be used to open the anterior chamber angle, increase the outflow through the trabecular meshwork and reduce the IOP. The present review will summarize the recent available literature regarding the role of both interventions for the treatment of glaucoma. Recent findings Recent articles have confirmed the effect of cataract surgery as an IOP-lowering procedure in people...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Co-management of cataract and glaucoma in the era of minimally invasive glaucoma surgery
We present a strategy for planning which surgery should be performed based on goals of care. Recent findings New clinical evidence for using the CyPass, Kahook and Xen45 devices has been published recently and is summarized. Summary Cataract and glaucoma frequently exist together. Because the field of glaucoma surgical care is expanding and cataract surgery is becoming progressively safer, it is important to frequently re-evaluate our treatment paradigms. We review and evaluate current studies and treatment options. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Cataract surgery in ocular surface diseases: clinical challenges and outcomes
This article discusses the challenges and outcomes of cataract surgery in complex cases targeting eyes with ocular surface diseases like Stevens–Johnson syndrome, ocular cicatricial pemphigoid, Mooren's ulcer, vernal keratoconjunctivitis and limbal stem cell deficiency. Recent findings Ocular surface diseases are commonly associated with corneal scarring and vascularization, conjunctival inflammation, symblepharon and forniceal shortening. Any surgical intervention in a hostile ocular surface environment may worsen the disease, which may result in visual deterioration. In recent past, with the use of immunosuppres...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Cataract surgery in eyes with keratoconus: a review of the current literature
Purpose of review There are an increasing number of keratoconic eyes, requiring cataract surgery. We review the preoperative planning, intraoperative options, and postoperative management that aid in successful outcomes. Recent findings Management of keratoconic eyes requiring cataract surgery requires a multifaceted approach. Preoperatively, corneal crosslinking and intrastromal corneal ring segments can be considered in order to provide stable keratometry values for intraocular lens (IOL) calculations. Deciding between toric and monofocal IOLs requires a thorough evaluation. Intraoperatively, the decision of clear c...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Management of cataract in uveitis patients
Purpose of review This review is timely because the outcomes of surgical invention in uveitic eyes with cataract can be optimized with adherence to strict anti-inflammatory principles. Recent findings All eyes should be free of any cell/ flare for a minimum of 3 months preoperatively. Another helpful maneuver is to place dexamethasone in the infusion fluid or triamcinolone intracamerally at the end of surgery. Recent reports about the choice of intraocular lens material or lens design are germane to the best surgical outcome. Integrating these findings will promote better visual outcomes and allow advancement in resea...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Dysphotopsia: a multifaceted optic phenomenon
Purpose of review To summarize the literature on dysphotopsia, focusing on strategies for management and prevention. Recent findings Clinical studies and ray-tracing diagrams have improved our understanding of the risk factors for positive and negative dysphotopsiae. Well known management and prevention strategies such as piggyback IOL, reverse optic capture, Nd:YAG capsulotomy, and IOL exchange are reviewed, as well as newer strategies such as the infertemporal approach to IOL implantation, ‘in-the-bag nasal optic truncation’ and new IOL design implantation, and new IOL design. Summary Positive and neg...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Femtosecond laser-assisted versus phacoemulsification for cataract extraction and intraocular lens implantation: clinical outcomes review
Purpose of review Femtosecond laser-assisted cataract surgery (FLACS) has gained popularity in recent years with the new technology suggesting potential improvements in clinical and safety outcomes over conventional phacoemulsification cataract surgery (PCS). A decade since the advent of FLACS has given time and experience for laser technology to develop in maturity, and better quality evidence to become available. This review evaluates current evidence on the clinical and safety outcomes for FLACS in comparison to PCS. Recent findings FLACS technology continues to improve and with it our confidence in tackling more c...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Prevention of macular edema after cataract surgery
Purpose of review Although cataract surgery can effectively restore visual function in many patients with cataract, PCME remains an important cause of suboptimal visual acuity. The present review provides an overview of the current literature on the prevention and treatment of PCME. Recent findings Optimal prevention of PCME starts preoperatively with a personalized risk assessment. Diabetes mellitus, retinal vein occlusion, epiretinal membrane, macular hole, and uveitis are the most important risk factors for developing cystoid macular edema after cataract surgery. Topical NSAIDs either in addition to, or instead of,...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Recent advances in small pupil cataract surgery
Purpose of review To highlight the existing and emerging cataract surgery trends in patients with insufficient mydriasis. Discuss the latest pharmacological approaches for pre and intraoperative pupil dilatation. Present the variety of newest pupil expansion devices; critically review their advantages and possible limitations to be considered by the surgeon. Recent findings The intracameral use of various mydriatic combinations augmenting the preoperative mydriatic instillations is currently gaining popularity in cataract surgery. Two main options are available: bolus injection of pharmacological agent or its constant...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Intracameral antibiotics during cataract surgery: evidence and barriers
Purpose of review There is continuing debate regarding the safety, efficacy, and necessity of intracameral antibiotics to prevent postoperative endophthalmitis. We summarize the most recent evidence-based publications that either support or caution against this practice. Recent findings Several additional large, international retrospective clinical studies found a significant reduction in endophthalmitis rates with intracameral antibiotic prophylaxis. Many surgeons are looking for alternatives to vancomycin for intracameral prophylaxis because of its association with the rare but sight-threatening complication of hemo...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

The use of povidone–iodine in ophthalmology
Purpose of review Povidone–iodine (PVI) is a disinfectant and antiseptic agent used for preoperative preparation of the skin and mucous membranes, as well as for the treatment of contaminated wounds. Currently regimens for prophylaxis against postsurgical endophthalmitis are being modified, including a total withdrawal of antibiotics in intravitreal injections. The aim of this study was to evaluate the use of PVI in ophthalmology. Recent findings As a result of its broad spectrum of microbicidal activity, PVI is routinely used in ophthalmic surgery. However, various protocols are applied worldwide and within dif...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Wound closure and tissue adhesives in clear corneal incision cataract surgery
Purpose of review Achieving secure wound closure in clear corneal incision cataract surgery remains highly desired for its role in reducing infection risk and leak-related complications, including hypotony, corneal edema, and lens dislocation. Although classic techniques of stromal hydration or wound suturing represent traditional approaches, the introduction of newer and more effective ocular surface adhesives has increased the options that are available. This review aims to provide an update on the peer-reviewed literature regarding wound closure and the currently available and investigational tissue adhesives used to ...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Astigmatism evaluation prior to cataract surgery
Purpose of review To evaluate and summarize literature from the past 18 months reporting advancements and issues in astigmatism assessment prior to cataract surgery. Recent findings New and updated toric calculators and regression formulas offer the opportunity for more accurate lens selection for our patients. Concurrently, improvements in topographic evaluation of corneal keratometry have allowed for a decrease in unplanned residual corneal astigmatism. Measuring posterior corneal astigmatism is especially valuable in eyes with keratoconus when planning to implant toric intraocular lens (IOL) and now allows access t...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Evaluation of the macula prior to cataract surgery
Purpose of review To describe recent evidence regarding methods of evaluation of retinal structure and function prior to cataract surgery. Recent findings Studies in patients with cataract but no clinically detectable retinal disease have shown that routine use of optical coherence tomography (OCT) prior to cataract surgery can detect subtle macular disease, which may alter the course of treatment or lead to modification of consent. The routine use of OCT has been especially useful in patients being considered for advanced-technology intraocular lenses (IOLs) as subtle macular disease can be a contraindication to the ...
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Advances in cataract surgery in patients with multiple ocular diagnoses
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - December 11, 2017 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research