Surgical simulators in cataract surgery training

AOA logo Surgical simulators in cataract surgery training Sikder S, Tuwairqi K, Al-Kahtani E, Myers W, Banerjee P; British Journal of Ophthalmology (BJO) (Oct 2013)

BACKGROUND Virtual simulators have been widely implemented in medical and surgical training, including ophthalmology. The increasing number of published articles in this field mandates a review of the available results to assess current technology and explore future opportunities.

METHOD A PubMed search was conducted and a total of 10 articles were reviewed.

RESULTS Virtual simulators have shown construct validity in many modules, successfully differentiating user experience levels during simulated phacoemulsification surgery. Simulators have also shown improvements in wet-lab performance. The implementation of simulators in the residency training has been associated with a decrease in cataract surgery complication rates.

CONCLUSIONS Virtual reality simulators are an effective tool in measuring performance and differentiating trainee skill level. Additionally, they may be useful in improving surgical skill and patient outcomes in cataract surgery. Future opportunities rely on taking advantage of technical improvements in simulators for education and research. (762)

Upper eyelid sulcus deepening with bimatoprost usage

AOA logo Upper eyelid sulcus deepening with bimatoprost usage

Upper eyelid sulcus deepening appears to be a frequent occurrence with bimatoprost usage, according to K. Inoue, MD, and colleagues.

They evaluated 250 eyes of 250 patients diagnosed with primary open-angle glaucoma or ocular hypertension. Five healthy patients were enrolled as controls. One eye of each patient was treated with latanoprost, travoprost, tafluprost, bimatoprost and isopropyl unoprostone in one eye for three months or more. Three ophthalmologists independently judged the appearance of the deepened upper eyelid sulcus in the (more…) (1278)

Femto-assisted ICRS implant for post-PKP high astigmatism

AOA logo Femto-assisted ICRS implant for post-PKP high astigmatism

Intrastromal corneal ring segment (ICRS) implantation using the femtosecond laser may be a viable alternative for high astigmatism correction in post-penetrating keratoplasty (PKP) eyes, according to C. Lisa and colleagues.

In the cohort study, 32 eyes of 30 patients with previous PKP underwent ICRS implantation after femtosecond tunnel creation. The uncorrected (UDVA) and corrected (CDVA) (more…) (1265)

Keratoplasty evolution has long and storied history

AOA logo Keratoplasty evolution has long and storied history

Corneal transplantation has a long and evolved history, with many facets of change and great future possibilities, Edward J. Holland, MD, Cincinnati, said.
Dr. Holland delivered the Castroviejo Lecture at the “Advances in Keratoplasty: Where we are in 2013” symposium.

The evolution of corneal transplantation began with an unsuccessful first attempt in 1838, followed by the discussion of the lamellar keratoplasty approach to corneal disease starting (more…) (597)

‘Pole to pole’ approach offers many advantages in severe ocular trauma

AOA logo ‘Pole to pole’ approach offers many advantages in severe ocular trauma

A “pole-to-pole” surgical approach in severe ocular trauma cases offers multiple ways to achieve the best results in a short time, and can also limit the amount of operations performed, reducing patient stress and the overall cost of the procedure, Cesare Forlini, MD, Ravenna, Italy, said.
Dr. Forlini delivered the Helen Keller Lecture at the “Anterior Segment Reconstruction” symposium, which took place on the final day of the American Academy of Ophthalmology meeting here in New Orleans. His talk was titled “Pole-to-pole approach in severe ocular trauma: focus on the middle earth – iris reconstruction and beyond.”
Pole-to-pole surgery “consists of a contemporary multidistrict surgical approach, alternating maneuvers (more…) (441)

“Spotlight on Cataract Complications” – AAO Meeting

AOA logo Learning from mistakes

Even in the hands of experts, not all cataract surgeries go as planned, as attendees at a “Spotlight on Cataract Complications” session found out during the second day of the American Academy of Ophthalmology meeting here in New Orleans. Session co-chair David F. Chang, MD, said the key is to remain calm.

“Don’t panic—take a deep breath,” he said, adding that even unwelcome events during surgery can result in good visual outcomes.

For instance, if there is a break in the anterior capsule, (more…) (2506)

Removing Retained Lens Fragments: Now or Later?

AOA logo Retained Lens Fragments After Cataract Surgery: Outcomes of Same-Day Versus Later Pars Plana Vitrectomy

Lens fragments, or even the entire lens, can become displaced into the vitreous cavity during the course of cataract surgery, as a consequence of a break in the posterior capsule or a loss of the intact peripheral zonular barrier. Although this complication is usually apparent during surgery, retained lens material may not be recognized for days or weeks after surgery.

When lens material begins to drop into the vitreous cavity, (more…) (2129)

Dry eye patients: the multistep approach

AOA logoDry eye patients: the multistep approach

When faced with a challenging dry eye patient, there are a number of key steps to take to ensure the best management and a happy patient, said Penny A. Asbell, MD, on Saturday at the Cornea Subspecialty Day.

These steps are:

-Listen: What is the complaint? What is the patient using? What therapies have been tried in the past and for how long?
-Rule out the use of the preservative benzalkonium chloride (BAK).
-Evaluate the patient for systemic diseases, including diabetes and Sjögren syndrome.
-Use keratography to measure tear breakup time, redness, and meibomian gland dysfunction.
-Examine the lids.
-Stop the patient’s current eyedrops and treat with the appropriate combination of cyclosporine, topical low-dose steroids, Lacriserts, autologous serum, or scleral contact lenses.—Mark Simborg

AAO Meeting 2013 (Cornea Subspecialty Day) (939)

Presbyopia treatments abound, but no clear standard

AOA logoPresbyopia treatments abound, but no clear standard

Corneal inlays, accommodating IOLs, and multifocal IOLs are all potential treatments for the correction of presbyopia, but none are ideal and ongoing improvements are needed, according to a panel discussion.

During Refractive Subspecialty Day, George O. Waring, III, MD, FACS served as judge with Daniel S. Durrie, MD, Jack T. Holladay, MD, MSEE, FACS, and Richard L. Lindstrom, MD, serving as jury members held court to put presbyopia surgery on trial.

There are three corneal inlays under (more…) (557)

Femto vs. phaco: technology trumps tradition

AOA logoFemto vs. phaco: technology trumps tradition (News from AAO meeting)

In a mock trial, complete with Eric D. Donnenfeld, MD, as a bewigged judge, it was decided that phacoemulsification cataract surgery will inevitably be replaced by laser. But many cataract surgeons still hold a place in their hearts—and their offices—for phaco, at least until femtosecond technology (more…) (891)

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