Eyeworld

EW CATARACT 87 April 2016 Save up to 64% compared to other iris expansion products! "For the cost, ease of use and effectiveness, the Xpand NT is absolutely the best pupillary expander available." - Charles H. Williamson, M.D., Baton Rouge, LA "The Xpand NT is an excellent, cost effective alternative for pupil expansion." - Richard J. Ruckman, M.D., Lufkin, TX "I have found the Xpand NT pupil expander to be the most effective device that allows me to perform femto second laser capsulotomy and lens fragmentation in patients with small pupils." - Y. Ralph Chu, M.D., Bloomington, MN "Xpand Your View" Visit us at ASCRS 2016 in Booth 744 DIAMATRIX Quality • Value • Innovation R 210 Nursery Road, The Woodlands, TX 77380 (T) 800.867.8081 (F) 281.292.5481 (W) www.diamatrix.com (E) info@diamatrix.com Doc 20160215 TM Conflict of Interest Statement: None of the physicians listed above have any financial interest in Diamatrix Ltd or its affiliated companies nor were they compensated for their statements. v Small MICS incision v Eight point iris fixation v Advanced titanium alloy v Quick, easy and secure iris engagement v Creates a nearly circular, 6.7mm diameter pupil v Available in both single-use and multi-use formats v Simple and intuitive insertion, placement and removal v Designed for minimal iris trauma during placement and removal to 1.56% when non-diabetic pa- tients had at least 1 risk factor. No increased risk was found among patients with high myopia, age-related macular degeneration (AMD), or prostaglandin analog use. Dr. Varma underscored the finding that prostaglandin use, AMD, and high myopia were not associated with a higher rate of PME as potentially affecting aspects of his clinical approach with cataract patients. "Therefore, there is no need to stop prostaglandins in a patient undergoing cataract surgery," Dr. Varma said. The postop impacts of PME included poorer visual acuity, which persisted for at least 24 weeks. Additionally, intraocular pressure was elevated significantly for up to 3 months after surgery. Patients with diabetes, even in the absence of retinopathy, had an increased relative risk of new macu- lar edema after surgery. The risk was higher in the presence of any diabet- ic retinopathy (DR) and rose propor- tionately with increasing severity of DR. The incidence of PME increased to 4.04% among diabetic patients who had a structured assessment of DR. "The association of severity of diabetic retinopathy to presence of PME is an important observation that deserves to be evaluated in the clinical setting," Dr. Varma said. Preventive therapy For the authors, the study findings highlighted the need for prophy- lactic therapy, especially in those groups of eyes with the highest rel- ative risks. Specifically, the authors wrote that the findings would allow clinicians to counsel patients more accurately on the risk and conse- quence of PME when undergoing cataract surgery, and would help in assigning the resources needed to better manage PME, such as the translation to clinical practice of newer prophylactic agents, like NSAIDs. Dr. Varma disagreed with that conclusion and said the need for prophylactic therapy in eyes with the highest risk is speculative and was not supported by the data in the study. "The value of prophylactic therapy in eyes at high risk for developing PME needs to be studied in randomized trials before advo- cating such an intervention," Dr. Varma said. EW Reference 1. Chu CJ, et al. Risk factors and incidence of macular edema after cataract surgery: a database study of 81984 eyes. Ophthalmolo- gy. 2016 Feb;123(2):316–23. Contact information Varma: rvarma@usc.edu

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