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Cataract Surgery Essentials or What All Patients Should Know About Cataract Surgery

One of our contributors, Dr. David Richardson, of San Gabriel Valley Eye Associates, has published an audio CD that answers questions commonly asked by patients undergoing cataract surgery. Among topics covered are how to choose an eye surgeon and information on advanced introcular lenses.

The audio format is an excellent choice for patients with a significant cataract that make it difficult to read books on the subject.

Dr. Richardson was trained at Harvard Medical School, is Board …

Does the NuLens IOL Represent a Breakthrough in Cataract Surgery?

One our contributors, Dr. David Richardson of San Gabriel Valley Eye Associates, recently wrote up a review of the NuLens® IOL from Israel on his blog entitled “NuLens IOL is No Optical Illusion.”

Dr. Richardson states that the NuLens IOL promises to allow cataract surgery patients to achieve a return to the same vision they enjoyed as teenagers. Dr. Richardson explains that unlike existing IOL’s on the market such as Crystalens, NuLens is made of a …

Acuvail vs. Nevanac Prior to Cataract Surgery

I am scheduled for cataract surgery later this week.  My doctor prescribed and gave instructions for me to use Acuvail (drops) twice daily and Zymar 4 times daily, for three days before surgery and afterward.  When I picked up the prescriptions, he had changed the Acuvail to Nevanac 3 times daily. What is the difference between Acuvail and Nevanac, and why might he have changed the prescription?  I believe both are NSAIDs.

InSite Vision Commences Phase 1/2 Clinical Study of ISV-303 for Post-Surgical Ocular Pain and Swelling Following Cataract and Other Surgeries

InSite Vision Incorporated, a company developing ophthalmic therapeutics, today announced the initiation of a Phase 1/2 clinical trial of ISV-303, a topical anti-inflammatory product intended to reduce the pain and inflammation associated with ocular surgery. ISV-303 combines a low dose of the non-steroidal anti-inflammatory (NSAID) bromfenac with InSite Vision’s proprietary DuraSite(R) technology. The randomized, placebo-controlled Phase 1/2 clinical trial is designed to evaluate the safety, efficacy and pharmacokinetics of ISV-303.

InSite’s DuraSite sustained delivery technology is …

SuperSelective Chemotherapy Prevents Enucleation

Administering chemotherapy by cannulating the ophthalmic artery in patients with retinoblastoma was very effective in resolving these tumors in children and prevented enucleation in 27/28 cases. No complications! The procedure was safely repeated up to six times. The cannulation was performed under fluoroscopic control, and this method avoids all the side effects of chemo.

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Glaucoma

IRIDEX Granted Patent for MicroPulse™ Technology for Dose Control of Laser Energy During Eye Surgery

On Thursday, IRIDEX announced the issuance of a patent covering its MicroPulse™ technology providing ophthalmologists with fine dose control of laser energy during eye surgery on patients suffering from diabetic retinopathy and other sight-threatening retinal and glaucoma disorders. According to the company, treatments using MicroPulse technology demonstrate favorable outcomes and significantly less damage to healthy retinal structures compared to traditional continuous wave laser treatment.

Laser products such as IRIDEXs’s IQ 577 that incorporate the MicroPulse control technology covered by …

Do Yellow Tinted IOL’s Affect SWAP Perimetry?

I never thought of this. In short wavelength automated perimetry (SWAP), blue/yellow is used instead of standard lights. According to a recent study, having one of those newer yellow tinted intraocular lenses that blocks blue light will affect color perception and thus the results of SWAP, which is used to measure visual field changes from glaucoma. We need to keep this in mind.

Is Frequency Doubling Technology Perimetry Superior to Standard Automated Perimetry in Detecting Glaucoma?

An article in Ophthalmology gives further support to what was demonstrated earlier- Frequency Doubling Technology (FDT) visual fields detect glaucoma earlier than Standard Automated Perimetry (SAP). Fellow normal eyes (by SAP), found to have glaucoma by FDT, were much more likely to develop glaucoma than those fellow eyes with normal FDT. A clever study. For several years, I have been very happy to switch my patients who hate SAP to FDT. It’s faster and is better- period. …

Will New Carbon Material Revolutionize Surgical Treatment of Glaucoma?

A new carbon “nanomaterial” recently developed at the University of Dayton Research Institute for multi-purpose use in aircraft coatings, wind turbines and other large-scale commercial applications may also improve the lives of glaucoma sufferers by reducing the number of surgical procedures needed to treat the disease.

Researchers noted that currently, when surgical treatment of glaucoma is required, a silicone shunt is implanted in the eye to facilitate drainage of excess fluid that is causing intraocular pressure …

Does a Modest Reduction in Intraocular Pressure Slow Vision Loss in Glaucoma Patients?

According to an article appearing yesterday on MedPage Today, a Canadian study has demonstrated that a modest reduction in intraocular pressure resulted in a significant slowing of visual field loss in patients with progressive glaucoma. Specifically, a 20% decrease in median intraocular pressure from 18 mm Hg to 14.8 mm Hg led to a reduction in rate of progression by a factor of three. Researchers noted that the slowed progression would be most clinically significant …

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Cataract

Cataract Surgery Essentials or What All Patients Should Know About Cataract Surgery

One of our contributors, Dr. David Richardson, of San Gabriel Valley Eye Associates, has published an audio CD that answers questions commonly asked by patients undergoing cataract surgery. Among topics covered are how to choose an eye surgeon and information on advanced introcular lenses.

The audio format is an excellent choice for patients with a significant cataract that make it difficult to read books on the subject.

Dr. Richardson was trained at Harvard Medical School, is Board …

Does the NuLens IOL Represent a Breakthrough in Cataract Surgery?

One our contributors, Dr. David Richardson of San Gabriel Valley Eye Associates, recently wrote up a review of the NuLens® IOL from Israel on his blog entitled “NuLens IOL is No Optical Illusion.”

Dr. Richardson states that the NuLens IOL promises to allow cataract surgery patients to achieve a return to the same vision they enjoyed as teenagers. Dr. Richardson explains that unlike existing IOL’s on the market such as Crystalens, NuLens is made of a …

Acuvail vs. Nevanac Prior to Cataract Surgery

I am scheduled for cataract surgery later this week.  My doctor prescribed and gave instructions for me to use Acuvail (drops) twice daily and Zymar 4 times daily, for three days before surgery and afterward.  When I picked up the prescriptions, he had changed the Acuvail to Nevanac 3 times daily. What is the difference between Acuvail and Nevanac, and why might he have changed the prescription?  I believe both are NSAIDs.

InSite Vision Commences Phase 1/2 Clinical Study of ISV-303 for Post-Surgical Ocular Pain and Swelling Following Cataract and Other Surgeries

InSite Vision Incorporated, a company developing ophthalmic therapeutics, today announced the initiation of a Phase 1/2 clinical trial of ISV-303, a topical anti-inflammatory product intended to reduce the pain and inflammation associated with ocular surgery. ISV-303 combines a low dose of the non-steroidal anti-inflammatory (NSAID) bromfenac with InSite Vision’s proprietary DuraSite(R) technology. The randomized, placebo-controlled Phase 1/2 clinical trial is designed to evaluate the safety, efficacy and pharmacokinetics of ISV-303.

InSite’s DuraSite sustained delivery technology is …

Do Yellow Tinted IOL’s Affect SWAP Perimetry?

I never thought of this. In short wavelength automated perimetry (SWAP), blue/yellow is used instead of standard lights. According to a recent study, having one of those newer yellow tinted intraocular lenses that blocks blue light will affect color perception and thus the results of SWAP, which is used to measure visual field changes from glaucoma. We need to keep this in mind.

Also...

Cornea

Is Preoperative Mitomycin Just as Good As Conjunctival Flap in Treating Pterygium?

In the AJO, researchers compared injecting a low dose of mitomycin in the pterygium one month before bare sclera surgery, and compared that to a conjunctival flap procedure. Remarkably, results were excellent in both groups. Mild whitening of the conjunctiva was noted in the mitomycin group, cosmetically acceptable. No other complications. Considering the low reimbursement rate for pterygium, I would consider this procedure, as my conjunctival autograft is a little time consuming considering how little …

Do Contact Lenses Cause Corneal Ulcers?

Researchers have recently found that contact lens wearers were about 9 times more likely to develop corneal ulcers than non-wearers (note for consumers: corneal ulcers are sores on the transparent front layer of the eye usually caused by viral or bacterial infections that frequently follow an injury as minor as a small scratch in the thin layer of tissue protecting the cornea).

The research was based on a study of 1,093,210 patients treated in the Northern California Kaiser …

How to Address Fuch’s Dystrophy After Cataract Surgery?

I wrote you awhile back and asked you about Fuchs Dystrophy and cataract surgery.  I had my surgery 2 months ago and my vision is only 20/70.  I don’t think at this point it will get any better, but my eye surgeon said my eye is not bad enough for a corneal transplant.  Do you think glasses will help my vision at this point or not?  I always like to find out why things happen …

Can Preconditioning Cornea Improves Transplant Success?

According to research reported on MedPage Today, topical treatments to “precondition” the corneal bed before transplantation may help the new cornea to succeed.  Researchers cautioned that this “preconditioning” effect still needs to be tested in trials by topical application of vascular endothelial growth factor (VEGF) inhibitors, such as bevacizumab (Avastin), ranibizumab (Lucentis), or novel agents.

Read the full story on MedPage Today.

International Stem Cell Corporation and Eye Hospital Launch Collaboration to Develop Stem Cell-Based Treatment for Corneal Vision Impairment

International Stem Cell Corporation, and Sankara Nethralaya Eye Hospital, a nonprofit medical facility in India, recently announced commencement of a collaboration to develop ISCO’s ‘CytoCor™’ stem cell-derived corneal tissue. The goal is to use CytoCor to treat corneal blindness and vision impairment.

CytoCor consists of transparent human tissue derived from pluripotent human stem cells. These structures are produced in the laboratory and recent testing at Sankara Nethralaya and laboratories in the US has demonstrated a range …

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Practice Tips

Should Ophthalmologists Add Hearing Services? Sell Hearing Aids?

A number of ophthalmologists have contracted with PHSI and other companies who either totally or partially provide turnkey operations where hearing services and subsequent sales of hearing aids are provided to patients. Some say it’s not ethical, but I disagree. the question is whether it’s appropriate. In other words, would it not be better to send these patients to hearing professionals or ENT?

Congress Delays Medicare Pay Cut

Hurray! Congress has voted to schedule a vote later this week to delay the 20% fee cut til May 1. They are also drafting legislation to ‘fix” this annual problem of reversing Medicare fee cuts, by freezing the fees for five years. Great idea, guys! Keep up the good work! I am seriously considering dropping Medicare, or, charging a mandatory $40 refraction fee for every visit. Otherwise, I really don’t see how my practice can …

Don’t Use Consult Codes

Medicare has now eliminated the use of consult codes in the office. You have to use the 92o04 or 992o4 codes (ophthalmology and E/M), but not that 99244 (consult). The difference is around $30-40. Of course, you’re going to end up treating the patient as a consult and writing a letter to the referring doctor like in any other consult, except you’re getting paid less, for no good reason. Yay!

Who’s Blowing Off Phaco When It Hits $500?

When (and it certainly seems like when and not if) phaco goes down to around $500, I will probably limit myself to straightforward cases, or maybe only those where I can implant a premium lens, and I will try to squeeze all my cases in 1 or 2 days a month. Otherwise, it makes no economic sense. I would imagine this is exactly what Medicare has in mind as a way to decrease reimbursements for …

Know Your Modifiers!

If you are in private practice, you MUST be familiar with the following three modifiers- otherwise, you are losing lots of money:

-24: This is added to the EXAM code (ie, 92012) during the post-op period (often 90 days after the procedure), when you are examining someone for a different diagnosis (i.e., conjunctivitis 1 month after cataract surgery). Without this modifier, the exam will be denied, as it will be assumed it’s a post-op visit.

-25: Add …

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Retina

IRIDEX Granted Patent for MicroPulse™ Technology for Dose Control of Laser Energy During Eye Surgery

On Thursday, IRIDEX announced the issuance of a patent covering its MicroPulse™ technology providing ophthalmologists with fine dose control of laser energy during eye surgery on patients suffering from diabetic retinopathy and other sight-threatening retinal and glaucoma disorders. According to the company, treatments using MicroPulse technology demonstrate favorable outcomes and significantly less damage to healthy retinal structures compared to traditional continuous wave laser treatment.

Laser products such as IRIDEXs’s IQ 577 that incorporate the MicroPulse control technology covered by …

Researchers Use Non-Viral Gene Therapy to Prevent Retinal Degeneration

Tufts University School of Medicine recently announced a study demonstrating that non-viral gene therapy can delay the onset of some forms of eye disease and preserve vision. The team developed nanoparticles to deliver therapeutic genes to the retina and found that treated mice temporarily retained more eyesight than controls. The study, published online in advance of print in Molecular Therapy, brings researchers closer to a non-viral gene therapy treatment for degenerative eye disorders.

The most common approach …

Is Retina Detachment Repair Emergent or Urgent?

AJO: 199 retinal detachment cases reviewed. In fovea-sparing cases, waiting up to three days was just as good as emergent surgery. A few weeks ago, an article noted that waiting a week to do ruptured globe also didn’t matter. But will the E.R. still call you at 3AM? Ubecha.

Should Lasers Be Used to Treat Eye Floaters?

I have just put online a unique look at a controversial subject, the use of the ophthalmic YAG laser to dissipate eye floaters. There are only 3 doctors in the U.S. that specialize in this technique: Dr. Scott Geller of Fort Myers, Florida; Dr. James H. Johnson of Irvine, California; and Dr. John Karickhoff of Falls Church, Virginia. I interviewed the three and present their perspectives on using lasers to eliminate bothersome “floaters”. An interesting …

Is Stem Cell Therapy Available to Treat Retinopathy of Prematurity?

I would like to konow if there is any self stem cell therapy available for retinopathy of prematurity? My six year old son has lost complete vision due to ROP (stage 5) in both eyes in his third month. I am living in India.

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