Refractive Surgery

In a recent wave of drug price increases that can only be explained by pharmaceutical manufacturers’ desire for profit maximization and which doctors and patients may call price gouging, the drug price war has been brought to the doorsteps of many eyecare providers. As optometrists are increasing their practice of medical optometry, patients are now calling their doctors about prior authorizations and unaffordable drug copays.

Cataract surgery is one of the most successful surgeries performed in the United States. By 2020, it is estimated the number of people having cataract surgery will double, and by 2030 it will triple. The optometrist’s role in comanaging these patients will be of critical importance. Developing and maintaining your post-operative clinical care skills is imperative.

One of the most common questions I hear every day from patients is, “What is new in refractive surgery?” I have asked Jim Owen, OD, an expert in refractive surgery technology, to discuss the latest version of LASIK-topography-guided LASIK-with David Geffen, OD, FAAO, who participated in Alcon’s Contoura Vision clinical trials.

A referral of your patient to a cataract surgeon seems straightforward. You refer when the vision is subjectively affected by lens opacification. But thinking out of the box will enable you to help your patients in ways you may not consider.

For years, I have been an advocate of early cataract surgery in any symptomatic patients. As we all know, the progression of cataract development is an unavoidable process, so why delay the inevitable?

In a landmark paper titled “Global consensus on keratoconus and ectatic diseases” published in the April 2015 issue of Cornea, Gomes et al sought to reach a consensus of the definition, concepts, clinical management, and surgical treatments of keratoconus and the family of corneal ectatic diseases.

We now live in the age of refractive cataract surgery. As optometrists, we think daily about refractive endpoints for glasses and contact lenses. But few think about it in terms of ocular surgery.

At present we are limited with our ability to treat presbyopes. Sure, we have progressives and multifocal contact lenses; however, from a surgical standpoint, monovision corneal refractive surgery is limited, and clear lens extraction is often extreme for emmetropes.

Corneal inlays to correct refractive errors are not new-various materials have been tried for more than 50 years to correct blurred vision. The greatest barriers to success of corneal inlays have been a lack of biocompatibility with the cornea, the difficulty of placing them within the corneal stroma safely, and refractive predictably.

The Centers for Disease Control and Prevention (CDC) recently told Women’s Health magazine that the reason some swimmers get red eyes after a dip in the pool isn’t the chlorine-it’s the urine in the water.

In October of 2009 the U.S. Food and Drug Administration (FDA), National Eye Institute (NEI), and the Department of Defense (DOD) launched the LASIK Quality of Life Collaboration Project (LQOLCP) to help better understand the potential risk of severe problems that can result from LASIK.

The landscape of cataract surgery has changed rapidly-first with premium intraocular lenses (IOLs) and now additional refractive cataract options such as laser-assisted cataract surgery (LACS) and intraoperative aberrometry.

Modern ophthalmic cataract surgery now employs sophisticated techniques to improve outcomes and patient satisfaction. This includes surgical systems providing better control, lasers to perform manual techniques, and intraoperative evaluation to evaluate surgical endpoints before the patient leaves the operating room (OR).

Years ago, I realized that a cataract is anomaly of the ocular system that should be eradicated at its earliest stages. Frankly, if you were in a relationship that was not going well and was destined to keep getting worse, would you stay?

Postoperative patients with PXF pose both short- and long-term concerns due to the underlying pathological changes that occur from the fibrillar deposition with some complications arising years after the surgery.

Before recommending laser vision correction for your patient, there are a number of factors you as an eyecare practitioner must consider.

A recent study found that the first punctum plug developed to treat inflammation and pain following cataract surgery has been shown to be a reliable alternative to medicated eye drops.

A recent study found that cataract surgery of the second eye improves the quality of life and visual function of the patient, above and beyond the benefits of the first eye surgery.

A study recently published in JAMA Ophthalmology found that long-term daily supplementation with selenium and/or vitamin E did not have a beneficial effect on cataract risk in men.

Last week, the Associated Press reported that at least 24 people lost vision after undergoing cataract surgery at a free medical camp, but a new report says doctors may be able to restore sight for at least six patients.

Gulden Ophthalmics recently introduced its new Premium IOL lens inserts to use in conjunction with its Cataract Eye model to educate patients on their premium intraocular lens (IOL) options.

When it comes to acronyms, there is no ophthalmic sub-specialty that compares to corneal surgical procedures. For example, let’s take a look at corneal transplants and therapeutic surface treatments. Among KLAL, DALK, PLK, LK, DLEK, DSEK, DSAEK, DMEK, and DMAEK, there is no wonder why there is so much confusion.

During the American Academy of Optometry's Academy 2014, leading researchers and clinicians detailed the latest knowledge regarding the origins of and treatments for keratoconus.

During the American Academy of Optometry's Academy 2014, Josh Johnston, OD, clinical director, Georgia Eye Partners, Atlanta, presented five pearls for successfully comanaging premium intraocular lens (IOL) patients.

Haag-Streit Surgical recently announced it added several new features to its intraoperative OCT system, iOCT.

Your patients may have seen wife of rapper T.I. and reality star Tameka “Tiny” Harris appear on Good Morning America this week to reveal she had undergone surgery to permanently change her brown eyes to “ice gray,” sparking a national conversation about the safety of such a procedure.

Bausch + Lomb recently announced that its next generation sub-micron gel formulation of loteprednol etabonate was statistically superior to placebo in eliminating inflammation and pain following cataract surgery by study Day 8, the primary endpoints in the first Phase 3, multi-center, double-masked, vehicle-controlled, parallel-group study.

Abbott recently announced that it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for two new products used in laser cataract surgery, the Cataract Operating System 3 (cOS3) and the Liquid Optics Interface 12, both for the company’s Catalys Precision Laser System.

Most of us would probably say that the vast majority of our patients are quite satisfied with the care they receive in our offices. But how do we know this for sure?

Advanced DNA testing for congenital cataracts can quickly and accurately diagnose a number of rare diseases marked by childhood blindness, according to a study published in Ophthalmology.