EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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March 2013 Reviewing continued from page 193 Important Safety Information Ð TECNIS¨ Multifocal IOL Caution: Federal law restricts this device to sale by or on the order of a physician. Indications: TECNIS® Multifocal intraocular lenses are indicated for primary implantation for the visual correction of aphakia in adult patients with and without presbyopia in whom a cataractous lens has been removed by phacoemulsification and who desire near, intermediate and distance vision with increased spectacle independence. The intraocular lenses are intended to be placed in the capsular bag. Warnings: Physicians considering lens implantation under any of the conditions described in the Directions for Use labeling should weigh the potential risk/benefit ratio prior to implanting a lens. Some visual effects associated with multifocal IOLs may be expected because of the superposition of focused and unfocused images. These may include a perception of halos/glare around lights under nighttime conditions. It is expected that, in a small percentage of patients, the observation of such phenomena will be annoying and may be perceived as a hindrance, particularly in low-illumination conditions. On rare occasions, these visual effects may be significant enough that the patient will request removal of the multifocal IOL. Under low-contrast conditions, contrast sensitivity is reduced with a multifocal lens compared with a monofocal lens. Therefore, patients with multifocal lenses should exercise caution when driving at night or in poor-visibility conditions. Patients with a predicted postoperative astigmatism >1.0D may not be suitable candidates for multifocal IOL implantation since they may not fully benefit from a multifocal IOL in terms of potential spectacle independence. Precautions: The central one millimeter area of the lens creates a far image focus; therefore, patients with abnormally small pupils (~1 mm) should achieve, at a minimum, the prescribed distance vision under photopic conditions; however, because this multifocal design has not been tested in patients with abnormally small pupils, it is unclear whether such patients will derive any near vision benefit. Autorefractors may not provide optimal postoperative refraction of multifocal patients; manual refraction is strongly recommended. In contact lens wearers, surgeons should establish corneal stability without contact lenses prior to determining IOL power. Care should be taken when performing wavefront measurements, as two different wavefronts are produced (one will be in focus (either far or near) and the other will be out of focus); therefore, incorrect interpretation of the wavefront measurements is possible. The long-term effects of intraocular lens implantation have not been determined; therefore, implant patients should be monitored postoperatively on a regular basis. Secondary glaucoma has been reported occasionally in patients with controlled glaucoma who received lens implants. The intraocular pressure of implant patients with glaucoma should be carefully monitored postoperatively. Do not resterilize or autoclave. Use only sterile irrigating solutions such as balanced salt solution or sterile normal saline. Do not store in direct sunlight or at temperatures over 45°C. Emmetropia should be targeted, as this lens is designed for optimum visual performance when emmetropia is achieved. Care should be taken to achieve centration. Adverse events: The most frequently reported adverse event that occurred during the clinical trial of the TECNIS® Multifocal lens was macular edema, which occurred at a rate of 2.6%. Other reported reactions, occurring in 0.3% –1.2% of patients, were hypopyon, endophthalmitis and secondary surgical intervention (including biometry error, retinal repair, iris prolapse/wound repair, trabeculectomy, lens repositioning and patient dissatisfaction). Attention: Reference the Directions for Use for a complete listing of indications, warnings and precautions. 2011.12.14-CT4390 Crispy skin salmon, pea salsa, and toasted cumin and beetroot salad Hellene and Minas Coroneo, M.D. Overall, the dish was a success. I'd absolutely make it again with the modification of adding blackening spices to the salmon. My favorite recipe of the bunch was the beetroot salad: a simple but tasty side featuring roasted beets and feta cheese. It was delicious, easy, and loaded with vitamins and minerals I felt good about eating. Another recipe to keep in my collection. Overall, "Feast Your Eyes" is a beautiful, educational collection of interesting recipes from around the world. It's an excellent way to promote the connection between eye health and diet. Source: Faith Hayden Source: Minas Coroneo, M.D. Prof. Coroneo is currently working on an American version of the cookbook, which he hopes will be available this year. Until then, the Australian version of "Feast Your Eyes" can be ordered online at amazon.com and the Genetic Eye Foundation website, www.gef.org.au, for $34.95. Proceeds from the book go to the Genetic Eye Foundation to help with the organization's research into eye diseases. EW Editors' note: Prof. Coroneo is co-author of "Feast Your Eyes." Contact information Prof. Coroneo: coroneom@gmail.com