As a new decade begins, Healio.com/OSN looks back at some of our biggest stories in the past 10 years. Over the years, ophthalmology has evolved to include new treatment options, both surgical and pharmaceutical, for numerous conditions affecting every part of the eye.
We have covered this news, along with peer-reviewed research, live meetings across the globe and in-depth articles regarding all things ophthalmology.
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Surgeons hold strong opinions for and against FLACS vs. manual cataract surgery
Careful planning needed in cataract cases with inflammation
Controlling inflammation key for cataract surgery in children with uveitis
Here are some of the most-read stories on Healio.com/OSN in the past decade:
Cataract surgery in diabetic patients poses more challenges
Diabetes is an increasingly common systemic malady, and many of our patients seeking cataract surgery have co-existing diabetic eye disease. While we can still deliver excellent results from cataract surgery, these patients are at an increased risk of complications and subsequent limitations of vision. With careful preoperative planning, attention to detail during phacoemulsification and close postoperative supervision, diabetic patients can achieve excellent vision with cataract surgery. Read more.
Raindrop near vision inlay approved, later recalled
In 2016, the FDA approved the Raindrop inlay (ReVision Optics), making it the first device to change the shape of the cornea to correct vision. However, in 2019, the Raindrop inlay was recalled due to an increased risk of corneal haze. Read more.
Surgeons hold strong opinions for and against FLACS vs. manual cataract surgery
Since its FDA approval in 2010, femtosecond laser-assisted cataract surgery has been an option for surgeons, a new method in their armamentarium along with the traditional manual phaco technique. However, opinions differ among surgeons regarding techniques, safety, complication rates and cost-effectiveness. Read more.
Steroids enable aggressive treatment of ocular inflammatory disease
Used alone or in conjunction with other pharmacologic or surgical treatments and in widely varied dosing regimens, steroids have proven to be effective in treating internal and external ocular inflammation. Read more.
Caffeine may be ally in preventing or retarding cataract
Caffeine accumulates in the lens capsule and epithelial cells after oral intake and may be a potential ally in the prevention of cataract, according to a study presented at the European Society of Cataract and Refractive Surgeons Winter Meeting in 2019. Read more.
Should I choose distance vision in both eyes, monovision, EDOFs or multifocals?
Deciding the refractive target and IOL for cataract surgery is a daunting task for both the surgeon and patient. The first two questions that must be answered are: Do you mind wearing glasses for intermediate and near tasks, and would the presence of halos and glare be acceptable in exchange for reducing your dependence on glasses? Read more.
Consider patient perception of pain when planning cataract procedures
Most surgeons believe only 10% of patients report pain during cataract surgery; however, studies have shown that the rate is significantly higher, with the majority of patients, if asked, experiencing some level of pain during the procedure, according to a 30-patient study. Read more.
Cataract surgery can be more challenging after vitrectomy
Pars plana vitrectomy is a safe, small-gauge, effective surgery that is essential in the treatment of a variety of posterior segment pathologies, including retinal detachments, diabetic retinopathy and macular lesions. But performing a vitrectomy, particularly with the use of intraocular gas, can induce cataracts, even in younger patients. Read more.
Alcon calls for surgeons to stop implanting CyPass micro-stent
The decision was based on safety data from the COMPASS-XT study, which found a statistically significant difference in endothelial cell loss at 5 years after surgery in patients who received the device in conjunction with cataract surgery compared to those who underwent cataract surgery alone. Read more.
FDA panel recommends approval of riboflavin, UV for keratoconus, corneal ectasia
Amid concerns about study data and labeling, a joint panel of the FDA’s Dermatologic and Ophthalmic Drugs Advisory Committee and Ophthalmic Devices Panel recommended approval of Avedro’s combined riboflavin ophthalmic solutions and ultraviolet light irradiation for corneal collagen cross-linking. Read more. The KXL System and two photoenhancers were approved by the FDA in 2016. Read more.
Excessive blinking may indicate ocular surface disease in children
Children are peculiar because they cannot always express themselves in a manner that adults can understand. For example, a toddler who gets headaches often exhibits this as tantrums or head banging. Similarly, there are times when children have a problem with their ocular surface, and instead of just rubbing their eyes, they will develop unusual eye movements and blinking that can be mistaken for neurological ticks. Sometimes these eye movements, and especially the blinking, can be so exaggerated as to cause great concern to parents. Read more.
Bimatoprost sustained-release implant reduces IOP in phase 3 study
A bimatoprost sustained-release implant reduced IOP by approximately 30% over 12 weeks in a phase 3 multicenter, randomized, masked, parallel-group study, which included 594 subjects with open-angle glaucoma or ocular hypertension. Read more. A new drug application for the implant is currently under review by the FDA, with action expected in 2020. Read more.
Several complications can result from pterygium surgery
Histologically, pterygium manifests with elastotic degeneration of the conjunctival substantia propria secondary to ultraviolet light. Indications for removal of this fibrovascular proliferation include with-the-rule or irregular astigmatism, ocular irritation, visual axis encroachment or threat thereof, difficulty with contact lens use, cosmesis, and restriction of extraocular movement. Problems can occur, though, with pterygium surgery. Read more.
DRCR.net Protocol T: At 2 years, Eylea, Avastin, Lucentis all reduce need for injections, improve visual acuity
Two-year results of the Diabetic Retinopathy Clinical Research Network Protocol T study show that about half the number of anti-VEGF injections needed to treat diabetic macular edema in the first year of the study were needed in the second year, regardless of which study agent was used. Read more.
Despite Plaquenil dosing recommendations, retinal toxicity remains
The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening. Read more.
Uveitis a complex disease, but treatable in most cases
Uveitis describes inflammation that exists in the uveal tract, but the disease course has such a variety of manifestations, iterations and presentations that no simple one-size-fits-all depiction may be appropriate. Read more.
FDA approves Alcon’s AcrySof IQ PanOptix trifocal IOL
PanOptix, which is already available in more than 70 countries, has been shown to deliver a combination of near, intermediate and distance vision while significantly reducing the need for glasses after surgery. Read more.
Overcoming the PRK mindset: Incorporating LASIK, SMILE into the military
The reason for undergoing refractive surgery as a member of the U.S. military is not necessarily a medical one. For this population, wearing glasses in combat would encumber aiming systems, helmets and faceguards. In many cases, glasses and contacts are an unsafe option for soldiers deployed to harsh or combat environments. Read more.
The dos and don’ts of DMEK
Descemet’s membrane endothelial keratoplasty is steadily becoming the globally preferred treatment option for patients with corneal endothelial disorders. Not every surgeon has made the switch, however, and the reason cited often is the perceived technical difficulty of the operation. Read more.
Johnson & Johnson to acquire Abbott Medical Optics for $4.325 billion
The acquisition will include ophthalmic products in cataract surgery, laser refractive surgery and consumer eye health, including over-the-counter drops for dry eye, solutions and cleaning systems for contact lenses, IOLs and advanced laser vision technologies. Read more.
