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Refractive Surgery Outlook: 2013 Archives

Read the clinical news from the 2013 issues of Refractive Surgery Outlook.

Outlook Features

December | The Changing Face of LASIK Candidacy

LASIK candidacy has changed dramatically over the years and continues to be refined as new diagnostic and therapeutic technologies adjust the risk-benefit ratio. Read more »

October/November | Ethics of Femtosecond Laser Cataract Surgery

How confident can surgeons be that they are offering patients a procedure that is better or safer than phacoemulsification-based surgery? What should they tell patients? And how should economics figure into the choices that surgeon and patient make? Read more »

August/September | Refractive Lens Exchange: A Procedure Whose Time Has Come?

Refractive lens exchange (RLE), the practice of correcting refractive error by removing a “clear” crystalline lens and implanting an IOL, was made possible by the convergence of improving surgical techniques and advancing intraocular lens (IOL) technology. The opinion of ophthalmologists on RLE is mixed. While many are guarded, others have embraced it enthusiastically. Read more »

July | WaveTec to Take Intraoperative Aberrometry International

Intraoperative wavefront aberrometry, a refractive cataract surgery tool that has stayed largely within the United States for several years, will be taking on a higher international profile this year. Read more »

June | Surface Ablation: Closing the Pain Gap with LASIK

While LASIK offers faster visual recovery with less pain than PRK, improved technology and better pain management have narrowed the gap between the two procedures. Read more »

May | It’s Back: Reconsidering Ortho-K

Following the publication of a long-term, randomized, controlled clinical trial showing orthokeratology slows the progression of childhood myopia, some ophthalmologists are taking a second look. They say the contact lens-based refractive intervention may become a practice builder in the long-run. That is, if past skepticism of orthokeratology, also known as ortho-k, can be overcome. Read more »

April | Managing Dysphotopsia in Multifocal IOL Patients

There are three types of post-cataract surgery dysphotopsia: positive dysphotopsia, in which patients experience bright arcs, rings, halos or streaks of light in the visual field; negative dysphotopsia, in which patients perceive an arc of darkness in the temporal region; and a third type—limited to patients with multifocal IOLs—that causes patients to experience split images and halos or rings around lights. Read more »

March | Back to the Future: Centering on the Corneal Vertex

In the early days of keratorefractive surgery, Pande and Hillman proposed that corneal surgeries should be centered on the spot where the visual axis meets the corneal plane — the corneal vertex — instead of on the pupil’s geometric center. They identified the coaxially sighted corneal light reflex as the visible landmark that best approximates the vertex’s location. In the two decades since that seminal paper, a smattering of studies have quietly added evidence supporting vertex centration. But this research has failed to dislodge the pupil center as the predominant centration point for excimer laser ablations. Read more »

February | Removing Epithelial Ingrowth: Laser vs. Glue

In a study that reviewed all LASIK procedures performed by a single U.S. surgeon over a 3.5-year period, there were no cases of visually significant epithelial ingrowth in 3,866 primary LASIK procedures. There were, however, 15 cases of epithelial ingrowth (2.3 percent) in the 646 flap-lift retreatments he performed.1 A study conducted in Turkey in which all flaps were created with a femtosecond laser reported just two eyes with clinically significant epithelial ingrowth in 6,415 primary procedures.2 But of the 108 eyes in that group that underwent relift for enhancement, two eyes (2 percent) experienced clinically significant epithelial ingrowth. Read more »

January | New Dry Eye Technology Could Improve Refractive Outcomes

One of the most important steps a refractive surgeon can take to improve visual outcomes is to find and treat every undiagnosed case of dry eye, blepharitis and meibomian gland dysfunction (MGD) among prospective patients. This interest in dry eye detection has led some surgeons to adopt new diagnostic tools and innovative treatments. Read more »

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