Breaking News Related to Macular Degeneration, Cataract, Glaucoma, Corneal Disease and Other Eye Conditions » Cataract

Excellent DVD From Dr. Arbisser Regarding Unplanned Vitrectomy

Dr. Ari Weitzner — Tue, 31 Jan 2012 09:30:51 +0000

I received a DVD from Cataract and refractive Surgery Today. It’s about an hour of discussion and clip from Dr. Lisa Arbisser, a well-known surgeon, who goes into clear detail exactly what to do and not do when faced with posterior capsular rupture and vitreous presentation. The clips are also on Eyetube. I think this DVD should be required viewing from all surgeons, especially those early in their careers. Her advice can really make the difference in our patients’ vision.

New Technique From Dr. Agarwal to Address Capsular Bag Weakness

Dr. Ari Weitzner — Mon, 30 Jan 2012 09:25:51 +0000

Dr. Agarwal describes a new technique for capsular bag weakness that builds on his “glued IOL” technique. It’s a hemi-ring segment made of haptic material that has a scroll that engages the capsule like the Malyugin ring does to the iris. It has a long segment that can be grasped with microforceps through a sclerotomy, and embedded in the sclera like the glued IOL. Check it out in January’s OSN.

Capsule Membrane Suture Fixation

Dr. Ari Weitzner — Mon, 16 Jan 2012 09:17:12 +0000

January Archives: Dr. Gimbel describes a technique for suturing the haptic and capsule together to the sclera for dislocated IOL’s. The description is not so clear to me, and there is no accompanying video, so I am not exactly sure how it works. Anyway, he got good results with no cheese-wiring that one would expect when passing 10-0 suture through the capsule. I hope to see a video soon on Eyetube.

Light Adjustable Lens Works

Dr. Ari Weitzner — Wed, 21 Dec 2011 09:34:51 +0000

December Archives: The light adjustable IOL (LAL) was evaluated over an 18 month period, and was found to successfully and precisely correct up yo 2.25D in sphere and 2.75D in cylinder, stable for at least 18 months. Briefly, the IOL is subject to ultraviolet light in a precise manner to change the shape of the IOL, by selectively stimulating sensitive portions of the lens which adjust their shape in response to the light. I don’t know about you, but I can’t wait to try this.

IOL No Better Than Contact Lens In Infants

Dr. Ari Weitzner — Mon, 19 Dec 2011 09:32:14 +0000

December Archives: A study comparing IOL to contact lens for infants undergoing cataract surgery confirmed an earlier study that I read last year or so, namely, that remarkably, the contact lens group did just as well as the IOL group. (One would think that most infants will not wear a contact lens with any regularity- at least that’s how it was when I was a resident). In the current study following patients for one year, the IOL group had far higher incidences of complications and adverse events. Seems to me the issue is pretty settled.

Can Cataract Incisions Be Too Small? Yep

Dr. Ari Weitzner — Wed, 14 Dec 2011 14:45:00 +0000

Ophthalmology Times: Dr. Vasavada examined tissue samples of eyes that underwent 2.2mm vs. 1.8 mm incisions, and found greater damage and collagen denaturation in the latter. I’m not surprised. I have read several pieces of the difficulty some surgeons have in the learning curve t0 1.8, and I assume there is more manipulation and stretching. I have not read anything that suggests 1.8 is significantly better astigmatically compared to 2.2, and I doubt it’s worth the time and expense and skills needed to adjust to such a small incision, unless the instrumentation takes a giant leap.

Loteprednol vs Prednisolone to Treat Intraocular Inflammation Following Cataract Surgery in Children

Dr. Ari Weitzner — Tue, 06 Dec 2011 09:23:05 +0000

Bausch & Lomb, Inc. is getting ready to launch a study that will evaluate the efficacy and safety of topical Loteprednol Etabonate (LE), 0.5%, to Prednisolone Acetate 1%, for the treatment of postoperative inflammation following ocular surgery for childhood cataract.

Children up to 11 years old who are candidates for routine, uncomplicated surgery for childhood cataract are eligible, subject to certain exclusion criteria.

Click here for further details.

Dr. Agarwal Does It Again- New technique To Prevent Nucleus Drop

Dr. Ari Weitzner — Mon, 28 Nov 2011 12:56:23 +0000

OSN: As anyone who watches ophthalmology videos or goes to conferences knows, Dr. Agarwal from India is one of the most fearless, innovative and skilled eye surgeons in the world. He describes a brilliant, elegant way to prevent nuclear pieces from dropping into the vitreous after a posterior capsule rupture. He levitates the pieces into the anterior chamber with OVD, then inserts a foldable 3 piece IOL into the anterior chamber over the iris. This acts as a barrier, and phaco proceeds over the IOL. Once the nucleus is removed, the capsule can be inspected and the IOL positioned into the sulcus or sutured to iris (or glued to sclera).

Toric Lens Implant for Patient With Cataract and Astigmatism?

Patient Letter to the Editor — Fri, 18 Nov 2011 12:49:19 +0000

Hi! I just had my visit with an ophthalmic surgeon to address the cataract in my left eye (my right eye is doing fine at this point).

I have always had an astigmatism in my left eye, and the doctor has recommended the toric lens implant.

My question is this: if I’m still going to need “readers” afterwards, why not just get the regular lens and just continue wearing my glasses? Opinions?

A Plug for Extracapsular Cataract Extraction over Phaco

Dr. Ari Weitzner — Thu, 17 Nov 2011 09:37:28 +0000

EyeWorld: The lack of training of extracapsular cataract extraction (ECCE) has struck some educators as being a problem- it’s really a good operation, and it really comes in handy when one has a very compromised eye. In fact, it’s probably the better choice than phaco in several scenarios. I did half my cases as ECCE as a resident- I’m really good at it. Residents today sometimes barely do a handful, if that. At UCSF, they decided to compare ECCE with phaco, and found a similar complication rate. They therefore feel there is no ethical dilemma in exposing patients and resident surgeons to this technique instead of phaco. I agree- ECCE should not be a lost art… just yet.