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Corneal ectatic disorders, such as keratoconus, progressively weaken corneal integrity, leading to thinning, irregular astigmatism and visual deterioration.1 Typically progressive in nature, these ectasias result in increasingly thinner corneas, causing the cornea to protrude forward into a cone shape. This leads to increasing amounts of myopia and astigmatism – both regular and irregular – as the disease […]

US OPHTHALMIC REVIEW – VOLUME 4 ISSUE 2 – FALL 2011

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Foreword

In cataract surgery, the race is on to create the smallest wounds possible to safely extract the cataract. How small can you go? Does it really matter if the incision size is 0.8 or 1.8 mm? Are we compromising maneuverability in regards to surgical technique? In this issue, Kumar and Agarwal discuss the ‘microphakonit’ method, […]

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Editorial

The concept of refractive cataract surgery became officially recognized and validated in the US following the 2005 Centers for Medicare and Medicaid (CMS) ruling allowing ophthalmologists to bill Medicare patients separately for presbyopia-correcting intraocular lenses (IOLs). This formalized a very critical distinction in the minds of patients, surgeons, and third-party payors. Health insurance covers medically […]

Advanced phacoemulsification (phaco) technology and techniques, as well as intraocular lens (IOL) developments, have dramatically heightened expectations for the cataract patient; emmetropia and instant visual improvement without discomfort or redness is the new norm. In my opinion, few patients are specifically informed that retinal detachment occurs after 0.5–1 % of phaco procedures. Careful pre-operative examination […]

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Imaging

Adaptive Optics Imaging—The Basics Before getting into the clinical utility of adaptive optics imaging technology, it is prudent to first review the basic principles of imaging with adaptive optics. With conventional optical imaging, the major factor limiting the achievable resolution is the eye’s monochromatic aberrations, which are due to imperfections in the optics of the […]

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Glaucoma

For years the question as to whether blood flow plays a role in the pathogenesis of glaucomatous damage has been controversial. The large number of publications on this topic illustrates this and a review is warranted. Herein we discuss the questions asked most often. Can We Measure Ocular Blood Flow? Indeed, it is challenging to […]

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Surgery

In recent years, non-penetrating glaucoma surgery has been seen as a safer alternative to trabeculectomy. This class of procedures is mainly represented by ‘deep sclerectomy’, ‘viscocanalostomy,’ and ‘canaloplasty’ (a recent and more reproducible variation of viscocanalostomy). The aim of all these procedures is to allow drainage of the aqueous humor from the anterior chamber, not […]

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Anterior Segment

The current objective or goal in cataract surgery is to achieve the preferred visual outcome with minimal trauma to the cornea. The advances in phacoemulsification techniques and phaco machines, along with the invention of foldable intraocular lenses (IOLs), made clear corneal incisions of less than 3 mm size possible.1–13 The main advantages of the smaller […]

Cataract surgery is the most commonly performed surgery in the US today, with an estimated 1.8 million procedures completed annually.1 Historically, post-operative medication regimens following cataract surgery have included an antibiotic drop and a topical steroid to control inflammation. Steroids, however, are associated with certain side effects including delayed wound healing, susceptibility to infection, and […]

Bepotastine besilate is a non-sedating, highly specific histamine-1 (H1) receptor antagonist and a potent mast cell stabilizer with inhibitory activity against eosinophil differentiation, activation, and migration, as well as several other inflammatory pathways.1–4 In animal models of allergic conjunctivitis, bepotastine besilate has been shown to be a more potent inhibitor of vascular hyperpermeability than olopatadine, […]

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Posterior Segment

From an optical perspective, everyday objects are a myriad of points of light-emitting rays that, after penetrating the pupil of the eye, form an image on the retina. According to the laws of geometrical optics, when the optical system of the eye is well focused, each point of light in the object forms a point […]

Intraocular inflammation and related complications are important causes of vision loss in posterior segment disease. Inflammatory processes contribute to blood–retinal barrier breakdown, vascular leakage, and the development of vision-threatening macular edema (ME) in retinal vein occlusion (RVO), uveitis, diabetic retinopathy, and Irvine–Gass syndrome.1 Inflammation also has a key role in the development of neovascularization that […]

Age-related macular degeneration (AMD) is a common cause of irreversible vision loss among the elderly worldwide. It is estimated that approximately 30 % of adults older than 75 years have some sign of AMD and that approximately 10 % of these patients have advanced stages of the disease.1–4 AMD can be classified in two forms: […]

Age-related macular degeneration (AMD) is the leading cause of severe visual acuity (VA) loss in industrialised countries and its prevalence is increasing with the aging population.1,2 There are two forms of the disease – dry AMD and exudative AMD. Dry AMD is associated with drusen early on, followed by atrophy of the macula during the […]

Diabetic retinopathy remains the most frequent cause of newly diagnosed blindness in the working-age population. This is despite improvements in therapies for blood glucose and blood pressure control, and the many different treatment modalities that are currently available including laser, vitreous surgery, and intravitreal injections. Diabetic macular edema (DME) is the most common reason for […]

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Melanoma

Uveal melanoma represents approximately 5–6 % of all melanoma diagnoses, the second most common form of melanoma.1 Uveal melanoma differs from cutaneous melanoma in many respects. Clinically, nearly every patient with uveal melanoma is diagnosed with disease limited to the primary site of disease in the uveal tract (see Figure 1). Uveal melanoma cells are […]

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