Eyeworld

DEC 2016

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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EW NEWS & OPINION In the hands-on skills lab, attendees practice techniques they learned in a skills transfer session at the Combined Ophthalmic Symposium. Several ASCRS members participate in the "Pardon the Ophthalmology: Hot Topics in Cornea and External Disease" session at the ASCRS•ASOA Symposium & Congress. Source (all): ASCRS The ASCRS Film Festival Awards honor the best filmmakers in ophthalmology. 11 11 Slug: JCRS1216 Word count: 680 Images: n/a In the journal ... In vitro delivery performance assessment of a new preloaded intraocular lens delivery system Lixin Wang, MD, PhD, Patricia Wolfe, PhD, Alexis Chernosky, Sumit Paliwal, PhD, Khiun Tjia, MD, Stephen Lane, MD Investigators in this study of porcine eyes set out to determine how a new preloaded intraocular lens delivery system, UltraSert (Alcon, Fort Worth, Texas), compared to two other preloaded systems as well as the manual approach. Porcine eyes were divided into groups: those that received lenses with the UltraSert (system U), with the iSert (Hoya Surgical Optics, Chino Hills, California) (system S), with the Tecnis iTec (Abbott Medical Optics, Abbott Park, Illinois) (system T), and those in which the manual sys- tem was used (Monarch III D, Alcon). Investigators found that while all systems were successful in placing the IOL in the capsular bag, the one that had the smallest final incision size and the least corneal incision enlargement was system U. With system S, investigators saw an associated split in the nozzle tip. Meanwhile, with system T even after exiting the nozzle the IOL continued to stick to the plunger tip in more than 50% of cases. There was one case of a trapped trailing haptic during lens delivery with systems S and T. Investigators concluded that system U with its depth guard nozzle tip had the fewest complications during IOL delivery, showed an absence of nozzle tip splitting, and had the least incision enlargement. Effect of postoperative administration of nonsteroidal anti-inflammatory drugs and steroids on the conformational changes in cataract wound healing Eun Young Choi, MD, Hyun Goo Kang, MD, Tae-im Kim, MD, PhD, Eung Kwoen Kim, MD, PhD, Hyung Keun Lee, MD The aim in this prospective randomized study was to consider how postoperative use of nonsteroidal anti-inflammatory drugs or steroids affected changes in clear corneal incision healing. Included here were 59 eyes undergoing cataract surgery. Of these, 29 were given bromfenac 0.1% postoperatively while 30 others were given predniso- lone acetate 1.0%. Investigators determined that in the bromfenac group between the 1-week and 3.5-week postoperative period, epithelial detachment or defect of a larger size was seen more frequently, but the 6-month follow-up showed that there were no significant differences in overall changes in wound instability between the groups. However, at the 1-week postoperative mark surgically induced astigmatism was cor- related with wound instability. Investigators concluded that when it came to changes in cataract wounds there were no significant differences due to postoperative adminis- tration of NSAIDs or steroids. However, in the bromfenac group there was an increase in epithelial defect or detachment. Outcomes and complications of excimer laser surgery in patients with collagen vascular and other immune-mediated inflammatory diseases Julie Schallhorn, MD, MS, Steven Schallhorn, MD, Keith Hettinger, MS, Jan Venter, MD, Martina Pelouskova, MSc, David Teenan, MD, Stephen Hannan, OD How do those with immune-mediated inflammatory diseases fare with excimer laser surgery? That was what investigators set out to determine in this retrospective case series. Here investigators reviewed files of 622 excimer laser patients who had under- lying diseases, albeit all well-controlled with no symptoms, at the time of undergoing refractive surgery between 2008 and 2015. Of those included, 50.6% of patients had rheumatoid arthritis, 19.5% had systemic lupus erythematosus, 10.5% had psoriatic ar- thritis, 10% had sarcoidosis, 6.4% had ankylosing spondylitis, 1.9% had multiple scle- rosis, and 1.1% had scleroderma. The majority of patients here underwent LASIK, with 9% undergoing PRK. Those included who underwent LASIK preoperatively had acuity ranging from –10.13 D to +4.13 D, while those who underwent PRK were between –9.5 D and +4 D. Following treatment, 81.8% of LASIK patients were within 0.5 D of target, as were 82.3% of PRK cases. Of the LASIK patients, 76.8% attained 20/20 acuity or better as did 73.4% of eyes that underwent PRK. For the most part, complications seen were the same as those that would be expected with the disease. However, in one case there was a peripheral flap melt that fortunately was responsive to topical steroid treat- ment. The conclusion reached was that for those with well-controlled immune-mediat- ed inflammatory diseases, excimer laser surgery can be safely performed. December 2016

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