Techniques of noncircular corneal transplantation
Purpose of review The management of peripheral corneal diseases, including Mooren's ulcer, Terrien's marginal degeneration, peripheral ulcerative keratitis and pellucid marginal degeneration is challenging. Circular grafts must either be very large, resulting in the excision of healthy tissue, or eccentric, leading to high levels of astigmatism. This review summarizes the range of noncircular keratoplasty procedures available to surgeons, in addition to their indications, and surgical techniques. Recent findings Noncircular grafts have been demonstrated to be useful in the management of peripheral corneal diseases. Th...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Risk factors for postlaser refractive surgery corneal ectasia
Purpose of review To summarize newly reported and update previously known risk factors for post laser vision correction (LVC) corneal ectasia. Recent findings Advances in corneal topography and tomography have improved detection of preclinical ectasia-related changes. This has allowed for enhanced screening of surgical candidates. There are also known genetic predispositions for corneal ectasia, and recent genetic analyses have revealed various genes and inflammatory biomolecular markers related to corneal biomechanical integrity. Other models of risk assessment such as finite element biomechanical modeling and artifi...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Intraocular lens calculations in patients with keratoectatic disorders
Purpose of review Intraocular lens (IOL) calculations in patients with keratoconus and other keratoectatic disorders continues to be a challenge for today's cataract surgeon. In this article, we review data published over the past 18 months (June 2018 to January 2020). Recent findings Cataract surgery in keratoconus patients has the potential to greatly improve patients’ vision. However, keratoconic eyes are notorious for unpredictable outcomes because of difficulty in obtaining proper preoperative biometry and lack of data and consensus on IOL calculation formulas that can reliable in providing the desired outc...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Potential benefits of modified corneal tissue grafts for keratoconus: Bowman layer ‘inlay’ and ‘onlay’ transplantation, and allogenic tissue ring segments
Purpose of review Keratoconus can be surgically challenging, especially in advanced cases. Classic corneal transplantation techniques, may often be associated with complications. New alternative procedures like isolated Bowman layer transplantation (as a corneal stromal inlay or as a corneal onlay) and corneal allogenic intrastromal ring segments (CAIRS) have recently shown promising results. The aim of this review is to describe the main new surgical developments for treating keratoconus. Recent findings Intrastromal Bowman layer transplantation has recently shown to be effective in halting keratoconus progression an...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Optimizing outcomes for keratoplasty in ectatic corneal disease
Purpose of review Advanced keratectasia often requires corneal transplantation for restoration of vision. This review discusses the surgical approach suitable for these cases including significant updates in the current literature. Recent findings With greater understanding of ectatic corneal disease and its associated operative challenges, several modifications in the surgical approach have been developed. Identified predictive factors for successful pneumatic dissection and intraoperative complications have informed surgical planning and decision-making. In the setting of failed pneumatic dissection, sequential use ...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Refractive approaches to visual rehabilitation in patients with keratoconus
Purpose of review As keratoconus is a chronic disease affecting young people, vision-related quality of life is often significantly impaired in patients with this disease. However, successful management of keratoconus, including visual rehabilitation strategies, can improve quality of life in these patients. This review will describe clinical approaches that improve vision-related quality of life in patients with stable keratoconus. Recent findings Several types of contact lenses including scleral lenses have been used successfully to manage keratoconus. Eyes with severe keratoconus, even those in which fitting with o...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Artificial intelligence in cornea, refractive, and cataract surgery
Purpose of review The subject of artificial intelligence has recently been responsible for the advancement of many industries including aspects of medicine and many of its subspecialties. Within ophthalmology, artificial intelligence technology has found ways of improving the diagnostic and therapeutic processes in cornea, glaucoma, retina, and cataract surgery. As demands on the modern ophthalmologist grow, artificial intelligence can be utilized to help address increased demands of modern medicine and ophthalmology by adding to the physician's clinical and surgical acumen. The purpose of this review is to highlight the...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Refractive surgery for the patient with autoimmune diseases
Purpose of review Autoimmune and immune-mediated diseases are considered contraindications for laser refractive surgeries according to the US Food and Drug Administration's guideline. This guideline, however, is based on limited case reports or complications reported during other intraocular procedures. There have been only a handful of new clinical studies that evaluate the efficacy and safety of refractive surgery in this specific patient population. The aim of this article is to review currently available research and offer updated recommendations for the evaluation and management of laser refractive surgery (LRS) in ...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Oculoplastic considerations for refractive procedures
Purpose of review Refractive surgery is one of the most popular elective procedures performed in the world. Given that dry eye is a common complaint following keratorefractive surgery, evaluation, and treatment of periocular conditions that further predispose the patient to dry eye symptoms is an important part of the presurgical assessment. Periocular conditions and surgeries can also affect the ocular surface and keratometry, and should be addressed. For example, ptosis, orbital fat herniation, ectropion, and eyelid masses have been shown to induce corneal topography changes and astigmatism. The oculoplastic considerat...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Preoperative, intraoperative, and postoperative assessment of corneal biomechanics in refractive surgery
Purpose of review To review current and emerging methods and utilities of preoperative, intraoperative, and postoperative measurements of corneal biomechanics and their effects on refractive surgery decision-making. Recent findings Several recent clinical and preclinical studies have demonstrated the utility of corneal biomechanical analysis in refractive surgery. These studies focus on both screening surgical candidates for keratoconic disease as well as intraoperative and postoperative monitoring. The measurement of spatially resolved biomechanics is beginning to be studied in humans. Summary Clinically available...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Redefining vision assessment
Purpose of review This review outlines ophthalmic diagnostic systems, which objectively evaluates the human visual system and its potential beyond that of Snellen acuity. Recent findings Advances in ophthalmic diagnostic systems have allowed for a deeper understanding of the optical principles of the human eye and have created the opportunity to evolve our current standards of vision assessment beyond Snellen acuity charts. Definitive comparative and validation trials will continue to be necessary in order for these advanced diagnostics to gain more widespread acceptance in the specialty, in addition to providing the ...
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Editorial: the new normal for refractive surgery
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 6, 2020 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Age-related macular degeneration therapy: a review
Purpose of review The purpose of this review is to describe the current clinical landscape of potential future therapies for both nonexudative (dry) and exudative (wet) age-related macular degeneration (AMD). We highlight some of the more promising treatments that are furthest along in development. Recent findings Patients with dry AMD have long been hoping for a highly efficacious treatment that may slow disease progression or even help regain vision. Patients with wet AMD have many effective treatment options but still there are those who have suboptimal responses or are burdened by the high frequency of treatment. ...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

The retina revolution: signaling pathway therapies, genetic therapies, mitochondrial therapies, artificial intelligence
Purpose of review The aim of this article is to review and discuss the history, current state, and future implications of promising biomedical offerings in the field of retina. Recent findings The technologies discussed are some of the more recent promising biomedical developments within the field of retina. There is a US Food and Drug Administration-approved gene therapy product and artificial intelligence device for retina, with many other offerings in the pipeline. Summary Signaling pathway therapies, genetic therapies, mitochondrial therapies, and artificial intelligence have shaped retina care as we know it an...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

The future of retinal imaging
This article reviews emerging technologies in retinal imaging, including their scientific background, clinical implications and future directions. Recent findings Fluorescence lifetime imaging ophthalmoscopy is a technology that will reveal biochemical and metabolic changes of the retina at the cellular level. Optical coherence tomography is evolving exponentially toward higher resolution, faster speed, increased portability and more cost effective. Adaptive optics scanning laser ophthalmoscopy fluorescein angiography will provide unprecedented detail of the retinal vasculature down to the level of capillaries, enabling...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Improving outcomes in retinal detachment: the potential role of rho-kinase inhibitors
Purpose of review Retinal detachment initiates a series of events that lead to degenerative changes in retinal synaptic architecture as well as the well-known phenomena of gliosis and photoreceptor apoptosis. Retinal reattachment does not always result in complete visual recovery, even if the fovea is not directly involved in the detachment. Rho-kinase (ROCK) inhibitors may mitigate some of these deleterious changes including disruption of synaptic architecture, photoreceptor apoptosis, and initiation of the epithelial-mesenchymal transition that characterizes proliferative vitreoretinopathy (PVR). This review focuses on...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research

Clinical comparison of 27-gauge and 23-gauge instruments on the outcomes of pars plana vitrectomy surgery for the treatment of vitreoretinal diseases
Purpose of review To compare outcomes of 27-gauge and 23-gauge pars plana vitrectomy (PPV) for treatment of vitreoretinal diseases. Recent findings Sixty-eight patients undergoing microincisional PPV for treatment of vitreoretinal diseases were randomized 1 : 1 to 27-gauge or 23-gauge surgery with a 7500 cuts-per-minute vitrectomy probe. The most common reasons for vitrectomy were epiretinal membrane (49%) and vitreous hemorrhage (24%). Mean ± standard deviation (SD) changes from immediate preoperative to immediate postoperative intraocular pressure were −0.40 ± 6.60 mmHg in the 27-ga...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Local treatment of infectious and noninfectious intermediate, posterior, and panuveitis: current concepts and emerging therapeutics
Purpose of review Local therapeutics play an important role in the management of infectious and noninfectious uveitis (NIU) as well as certain masquerade syndromes. This review highlights the established therapeutics and those under investigation for the management of uveitis. Recent findings An injectable long-acting fluocinolone acetonide insert was recently approved by the Food and Drug Administration for the treatment of NIU affecting the posterior segment. Intravitreal methotrexate, sirolimus, and anti-vascular endothelial growth factor (VEGF) agents are being evaluated for efficacy in NIU. Intravitreal foscarnet...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Complications of vitreoretinal surgery
Purpose of review The present article reviews the most common and most serious vision-threatening and life-threatening complications of vitreoretinal surgery. Recent findings Serious complications after vitreroretinal surgery are rare. Endophthalmitis for example has recently been estimated to occur in 0.08% of small gague vitrectomy. Other complications such as cataract are almost unavoidable, becoming visually significant in up to 80% of patients. The introduction of smaller gauge vitrectomy systems has reduced surgical times, conjunctival scarring and inflammation, and the rate of some complications such as retinal...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Scleral fixated secondary intraocular lenses: a review of recent literature
Purpose of review A variety of techniques exist for secondary intraocular lens (IOL) implantation. Of note, scleral fixated intraocular lenses have become more popular with a variety of techniques, both with and without use of sutures. Herein, we focus on reviewing recently published studies describing the long-term outcomes of scleral fixation techniques. Recent findings Although initial papers describing novel techniques often report short-term outcomes, several studies have recently described intermediate and long-term outcomes for scleral fixated IOLs, albeit all being retrospective case series. Suture fixation me...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Recent developments in pediatric retina
Purpose of review Pediatric retina is an exciting, but also challenging field, where patient age and cooperation can limit ease of diagnosis of a broad range of congenital and acquired diseases, inherited retinal degenerations are mostly untreatable and surgical outcomes can be quite different from those for adults. This review aims to highlight some recent advances and trends that are improving our ability to care for children with retinal conditions. Recent findings Studies have demonstrated the feasibility of multimodal imaging even in nonsedated infants, with portable optical coherence tomography (OCT) and OCT ang...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Gene therapy beyond luxturna: a new horizon of the treatment for inherited retinal disease
Purpose of review Gene therapy offers, for the first time, the possibility to cure diseases such as retinitis pigmentosa. The positive outcomes that led to the U.S. Food and Drug Administration (FDA) approval of Luxturna to treat Leber congenital amaurosis caused by RPE65 mutations created an optimistic atmosphere in the research, clinical and patient community. Despite this first success, we must understand that this is not a ‘one treatment for all’. This review aims to explain the basic concepts of gene therapy and how they translate in different approaches that are utilized in ongoing clinical trials here ...
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - April 3, 2020 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Circumferential canal surgery: a brief history
Purpose of review Most microinvasive glaucoma surgery (MIGS) procedures bypass outflow resistance residing proximally in the trabecular meshwork and inner wall of Schlemm's canal. A novel procedure combining trabeculotomy with viscodilation adds to this by also addressing distal resistance of the canal and collector channel ostia. This review examines the development and evidence for both trabeculotomy and canaloplasty separately and the combination in a single procedure. Recent findings Recent aqueous angiography studies have confirmed the segmental nature of outflow through Schlemm's canal highlighting the need to a...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Subconjunctival microinvasive glaucoma surgeries: an update on the Xen gel stent and the PreserFlo MicroShunt
Purpose of review This review will provide an update on surgical techniques, outcomes, and complications for two new translimbal bleb-forming surgical glaucoma devices. Recent findings The XEN Gel Microstent and PreserFlo MicroShunt comprise a category of subconjunctival microinvasive glaucoma surgery developed with the aim of improving the predictability and safety profile of bleb-forming procedures. Both devices are made of noninflammatory material which limits postsurgical inflammation and scarring and have a valve-less intrinsic flow-limiting design, which decreases the risk of hypotony. There are various techniqu...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Contemporary management of refractory pediatric glaucoma
Purpose of review The management of pediatric glaucoma poses a unique challenge in terms of maintaining lifelong vision and combating an aggressive scarring response from surgery. Contemporary literature regarding the surgical management of children with pediatric glaucoma who fail, or are at a high risk of failure, from conventional surgery is limited. The aim of this review is to highlight recent developments in relation to the current opinion regarding the management of children with refractory pediatric glaucoma. Recent findings Some studies have reported impressive success rates with circumferential trabeculotomy...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Glaucoma in pregnancy: an update
Purpose of review Glaucoma management during pregnancy is a complex challenge, which requires balancing the clinical disease of the mother with the potential risks of therapy to the developing child. Because systematic studies are lacking in the pregnant population, this review aims to collect the array of available data from observational studies and case reports to provide the reader with guidance and context for the safety of glaucoma interventions during pregnancy. Recent findings Surgical glaucoma is a rapidly expanding field with many new technologies and procedures. We review the surgical options for the gravid...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Management of the glaucoma patient progressing at low normal intraocular pressure
Purpose of review Patients with glaucoma with disease progression despite low or normal intraocular pressure (IOP) present special challenges to the treating clinician. Treatment goals may depend on whether patients have apparent low IOP with concurrent treatment or have low IOP at baseline without treatment. We review the diagnostic and therapeutic approaches to these patients. Recent findings Apparent progression at low IOP should start with confirmation of IOP, made easier by devices enabling patient home self-tonometry. Suspected visual field progression should be confirmed by repeat testing prior to advancement o...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Primary angle closure glaucoma genomic associations and disease mechanism
Purpose of review The genetic basis of primary angle closure (PAC) glaucoma is slowly being elucidated. In recent years, genome-wide association studies have identified eight new susceptibility loci for PAC. Our purpose in this review is to summarize our current knowledge of genetics in angle closure, to take a closer look at the eight novel loci and what we have learned about their function, and consider what they might teach us about angle closure disease. Recent findings Multiple novel loci associated with PAC glaucoma have been identified in large genome-wide association studies. Moreover, primary open angle glauc...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Glaucoma screening: where are we and where do we need to go?
Purpose of review Current recommendations for glaucoma screening are decidedly neutral. No studies have yet documented improved long-term outcomes for individuals who undergo glaucoma screening versus those who do not. Given the long duration that would be required to detect a benefit, future studies that may answer this question definitively are unlikely. Nevertheless, advances in artificial intelligence and telemedicine will lead to more effective screening at lower cost. With these new technologies, additional research is needed to determine the costs and benefits of screening for glaucoma. Recent findings Using op...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Toward a new definition of glaucomatous optic neuropathy for clinical research
Purpose of review A process is ongoing to produce a definition of glaucomatous optic neuropathy (GON) using quantitative, objective data from structural and functional tests. At present, a common practice is to define GON by subjective features said to be ‘characteristic’ as judged by those experienced in glaucoma care. Recent findings An objective definition would standardize the comparison of clinical research results across studies, without precluding simultaneous use of idiosyncratic definitions in the same reports. To achieve this goal, expert opinion was solicited to reach optimal agreement on one or...
Source: Current Opinion in Ophthalmology - February 8, 2020 Category: Opthalmology Tags: GLAUCOMA: Edited by Donald L. Budenz Source Type: research

Vision 2020: where are we?
Purpose of review To describe the VISION 2020: The Right to Sight, global initiative for the elimination of avoidable blindness, the contribution of glaucoma to the magnitude of global blindness and priorities going forward. Recent findings Although the target of the World Health Organization's Global Action Plan (2014–2019) has not been met in terms of 25% reduction in avoidable blindness, there is evidence that the contribution of glaucoma to blindness and vision impairment is reducing. Yet this focus on a threshold of visual acuity by which to measure prevalence underestimates the true burden of glaucoma. Rec...
Source: Current Opinion in Ophthalmology - February 8, 2020 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, 2020 Category: Opthalmology Tags: EDITORIAL INTRODUCTION Source Type: research

Update: The Miller Fisher variants of Guillain-Barré syndrome: Erratum
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: ERRATUM Source Type: research

Manual small incision cataract surgery
Purpose of review To review various techniques of manual small incision cataract surgery (MSICS), updates on training residents and fellows, and cost-effectiveness of the surgery. Recent findings Recent population studies estimate that there are 53 million people blind worldwide from cataracts, up from previous figures. This is in part because of population growth and increased life expectancy worldwide. MSICS continues to play a significant role in addressing cataract burden and there is an increasing need to train surgeons in the technique. In response to this need, several modules and rubrics have been developed to...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Drop-free approaches for cataract surgery
Purpose of review Routine prophylaxis for adverse events following cataract surgery is evolving. Prior reliance on topical eyedrop instillation by patients is giving way to surgeon directed injections at the time of cataract surgery. The benefit of this new approach is assured delivery of drugs in standardized doses which should optimize the healing process and reduce the incidence of untoward events with higher confidence. Recent findings Adoption rates of intracameral antibiotic injection amongst European and American cataract surgeons is increasing. Techniques to inject periocular corticosteroid for routine inflamm...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

The quest for homeopathic and nonsurgical cataract treatment
This article reviews the current understanding of cataract development and discusses several homeopathic remedies purported to treat age-related cataract. Additionally, we will present an overview of evidence regarding the development of pharmacologic cataract reversal therapies. Recent findings Some homeopathic therapies have been shown to prevent cataract development in experimental models. More studies are required to elucidate the potential medicinal and toxic properties of the various alternative therapies. However, in recent years, scientists have begun to investigate substances that address cataract by reversing ...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Scleral fixation of intraocular lenses
Purpose of review To review current, effective and more popular techniques for scleral fixation of intraocular lens (IOLs) and IOL–capsular bag complex. Recent findings Scleral fixation of IOLs became popular, originally with sutured scleral fixated IOLs and later the Scharioth technique of intrascleral haptic fixation. This was further developed as the Glued IOL technique which enjoys widespread adoption all over the world. Recently the Yamane technique has also become popular and is being widely adopted as well. Summary Scleral fixated IOLs have evolved in the last 2 decades with technical modifications, ex...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Iris reconstruction suturing techniques
This article will review current suturing techniques for iris reconstruction, as well as the benefits and drawbacks to various suturing methods. Alternative reconstructive methods are also discussed. Recent findings One of the earliest iris suturing methods described was the McCannel technique. This technique allows direct suturing of the iris using three incisions. The Siepser slipknot is another method used in closed chamber iris suturing techniques. This knot, and its recent modifications, utilizes a sliding knot, which is created outside the eye and slid into place atop the iris defect. The cerclage iris suture, in ...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Methods for achieving adequate pupil size in cataract surgery
Purpose of review Cataract surgery is the most common surgical procedure performed worldwide. Small pupils have been an eternal challenge for cataract surgeons; insufficient pupil dilation is associated with increased complication rates, including capsule rupture, vitreous loss, iris trauma or postoperative inflammation. The aim of the current review is to present the methods for pupil dilation and the risk factors for a small pupil in a cataract patient. Recent findings Risk factors for intraoperative small pupil include diabetes, intraoperative floppy iris syndrome, pseudoexfoliation syndrome, receiving glaucoma med...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Hand hygiene and instrument sanitization in ophthalmology clinics
This article reviews the various challenges in infection control in eye clinics and successful measures taken to prevent nosocomial infections. Recent findings The Center for Disease Control recommends hand-washing when hands are visibly soiled, and after direct contact with patients, and inanimate objects such as medical equipment. Published studies have identified poor hygiene in clinical settings as a major cause of nosocomial outbreaks, particularly in cases of epidemic keratoconjunctivitis (EKC). Some studies of EKC outbreaks are able to support direct observation of hygiene lapses with molecular analysis that can ...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Cataract surgery in corneal transplantation
Purpose of review Corneal diseases are often associated with lens opacity. The present article reviews the recent advances in the management of cataract and corneal transplant. Recent findings Thanks to the development of lamellar transplant techniques and the evolution of cataract surgery, we now have several strategies to address corneal diseases and cataract including ‘lamellar triple procedure’. Numerous precautions have been identified to have a successful surgery with good visual recovery. Summary Corneal diseases associated with cataract can be successfully managed using separate or combined surg...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Cataract surgery and intraocular pressure in glaucoma
Purpose of review To review the current literature on the relationship between cataract extraction and intraocular pressure (IOP). Recent findings Cataract extraction can be an effective IOP lowering treatment for open and closed angle glaucoma as well as ocular hypertension. In comparative trials studying novel micro-invasive glaucoma surgeries in open angle glaucoma, the control group undergoing cataract extraction alone routinely achieved significant reductions in IOP and medication use postoperatively. Data from the Effectiveness in Angle Closure Glaucoma of Lens Extraction (EAGLE) trials have demonstrated that le...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

How much astigmatism to treat in cataract surgery
Purpose of review Astigmatism correction in cataract surgery is a common surgical challenge. Although there are numerous approaches to its treatment during cataract surgery, there remains a lack of consensus on what level of postoperative astigmatism to target. We examine the literature to determine the effect of astigmatism on visual function and provide a recommendation on how much to treat in cataract surgery. Recent findings Distance visual acuity decreases as myopic, hyperopic, or mixed astigmatism increases. Near visual acuity decreases with hyperopic astigmatism but improves with myopic astigmatism. The effect ...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Management of cataract in the setting of uveitis: a review of the current literature
Purpose of review This review aims to cover the preoperative planning, intraoperative considerations, and postoperative management that aids in successful outcomes of patients with cataract and uveitis. Disease-specific management and pediatric management will also be addressed. Recent findings Dexamethasone implants appear to be a safe and effective addition to standard steroid treatment in decreasing the incidence of postoperative cystoid macular edema (CME). Intravitreal steroids and topical difluprednate have shown utility in CME treatment. Summary Cataract surgery in eyes with uveitis is generally safe and eff...
Source: Current Opinion in Ophthalmology - November 29, 2019 Category: Opthalmology Tags: CATARACT SURGERY AND LENS IMPLANTATION: Edited by Natalie A. Afshari Source Type: research

Editorial: Surgical advancements and innovations in cataract surgery for the complex patient
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - November 29, 2019 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 - November 29, 2019 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Ocular manifestations of herpes simplex virus
Purpose of review To review ocular manifestations and complications of herpes simplex virus (HSV) and discuss recent advancements in diagnostic and treatment strategy. Recent findings In-vivo confocal microscopy has expanded our understanding of corneal nerve degeneration, corneal dendritic cell activity, and changes in biomechanical properties in HSV keratitis. Although currently available only as a research tool, metagenomic deep sequencing has the potential to improve diagnostic accuracy beyond the well established PCR technology, especially in atypical cases. Development of an HSV vaccine has shown some encouragin...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by John A. Gonzales Source Type: research

Floppy eyelid syndrome: ocular and systemic associations
Purpose of review To summarize the ocular and systemic associations of floppy eyelid syndrome (FES) as well as provide an up-to-date review on the pathogenesis and treatment strategies. Recent findings Virtually all patients with FES have obstructive sleep apnea (OSA). However, a significantly lower proportion of patients with OSA have FES. Although some studies demonstrate no association between OSA and FES, almost all show at least an association with increased eyelid laxity, which may be a less severe form of FES. FES has also been associated with keratoconus (KCN) and glaucoma. Decreased corneal hysteresis has bee...
Source: Current Opinion in Ophthalmology - October 4, 2019 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by John A. Gonzales Source Type: research