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Rivals Manual Technique CUTTING-EDGE ADVANCEMENTS February 15, 2014 VOL. 39, NO. 4 CLINICAL DIAGNOSIS SURGERY DRUG THERAPY OphthalmologyTimes.com FOLLOW US ONLINE: Laser refractive lens surgery Surgery TREATMENT TACTICS FOR LYMPHATIC RIVALS MANUAL TECHNIQUE MALFORMATIONS A Femtosecond laser brings both advantages and distinct challenges to lens procedure COLUMBUS, OH :: A DECADE of follow- up indicates percutaneous drainage and By Cheryl Guttman Krader; ablation of lymphatic malformations is VIDEO Reviewed by Michael Lawless, MD, and a safe and effective treatment. “We’re To watch the procedure, go to http:// Robert K. Maloney, MD able to achieve permanent remission bit.ly/1hgSOLh (Video courtesy of Robert K. Maloney, MD) and decrease the progression of the ACCUMULATING DATA PUBLISHED fibrotic component of these lesions,” in the peer-reviewed literature demonstrate that said Kenneth V. Cahill, MD, FACS. B laser refractive lens surgery (LRLS) performed with ( See story on page 13 : Lesions ) a femtosecond laser offers certain safety advantages compared with manual surgery. Special Report However, surgeons who undertake the laser- assisted procedure must be aware that unique safety issues ALGORITHM GIVES accompany it, making appropriate patient selec- tion critical. BOOST TO ALLERGIC “If we can remove unpredictable events, perform specific tasks with greater precision, decrease the CONJUNCTIVITIS chance of damage to collateral structures, introduce NEW BRUNSWICK, NJ :: AN ALGO- A The hydrodissection fuid wave is very subtle previously impossible maneuvers, and do all of that RITHM for the management of aller- in femtosecond laser treatment, because the wave reproducibly, then we have a safer operation,” said gic conjunctivitis aims to increase con- travels between epinucleus and cortex, rather than Michael Lawless, MD, medical director, Vision Eye sensus among a variety of specialists between cortex and capsule. It is important to Institute, Chatswood, NSW, Australia, and clinical notice the wave and not continue to inject, which who may be dealing with ocular allergy. senior lecturer, Department of Ophthalmology, Syd- could result in overpressurization of the bag and The algorithm also addresses comor- posterior rupture. ney University Medical School. bidities such as dry eye and the pos- sible impact on the ocular surface of B Complete free-foating capsulotomy. POINT: SAFER THAN MANUAL? (Image courtesy of Michael Lawless, MD) medications customarily used to treat “There is now a body of evidence in the peer- reviewed allergies, said Leonard Bielory, MD. literature from which we can say that LRLS has ( See story on page 21 : Allergy ) been shown to be or is likely to be safer than a manual procedure,” Dr. Lawless said. At the time of his discussion, he identified 74 pa- pers reporting on outcomes of LRLS, of which four were randomized controlled trials, 12 were con- trolled longitudinal studies, seven were considered to provide grade A or B evidence, and seven would be given a grade C evidence rating. Summarizing the findings, Dr. Lawless said that use of the laser creates more precise and more pre- ( Continues on page 18 : Safety ) magentablackcyanyellow ES390095_OT021514_CV1.pgs 02.15.2014 03:49 ADV Visual Performance. AcrySof ® IQ – The monofocal IOL proven to deliver excellent visual performance. Give your patients more time to react with the performance of AcrySof ® IQ IOL. CONFIDENCE For important safety information, please see adjacent page. © 2013 Novartis 2/13 NIQ13007JAD magentablackcyanyellow ES388118_OT021514_CV2_FP.pgs 02.05.2014 19:09 ADV :: FEBRUARY 15, 2014 Ophthalmology Times contents 3 28 Special Report on page 21 CLINICAL CONCEPTS IN OCULAR ALLERGY Surgery Clinical Diagnosis 13 6 DECODING CORNEAL 28 THE VITREOUS: SCARS TO 20/20 ORPHAN OF THE EYE Addressing anterior corneal Reversing degenerative changes scars with laser PRK may yield protective effect 13 TACTICS FOR 9 LYMPHATIC Drug T erapy MALFORMATIONS 34 ANTI-VEGF THERAPY: Therapy minimally invasive, Studies have shown that more preferable to surgical SAFETY TRENDS color vision discrimination resection Data provide limited insights is not adversely affected in on systemic effects individuals with the AcrySof® Natural IOL and normal color 14 CORNEAL INLAY vision. The effect on vision CAUTION : Federal (USA) law of the AcrySof® Natural IOL AND PRESBYOPIC InDispensable restricts this device to the in subjects with hereditary sale by or on the order of a THERAPY color vision defects and Long-term data show device 35 TRENDING: OPTICAL physician. acquired color vision defects gives boost to treatment INDICATIONS: The AcrySof® secondary to ocular disease DISPENSARY DESIGNS IQ posterior chamber (e.g., glaucoma, diabetic LED lighting, color contrasting, intraocular lens is intended retinopathy, chronic uveitis, 17 THREE SURGICAL and modernization transforming for the replacement of the and other retinal or optic optical displays human lens to achieve visual nerve diseases) has not been TIPS FOR ECP correction of aphakia in adult studied. Do not resterilize; patients following cataract do not store over 45° C; use WITH PHACO surgery. This lens is intended only sterile irrigating solutions Maximizing endoscopic Practice for placement in the capsular such as BSS® or BSS PLUS® cyclophotocoagulation bag. Sterile Intraocular Irrigating with cataract surgery Management Solutions. WARNING/PRECAUTION: Careful preoperative ATTENTION: Reference the 40 ‘OBAMACARE’ evaluation and sound clinical Directions for Use labeling AND EYE HEALTH judgment should be used for a complete listing of In Every Issue indications, warnings and DISPARITIES by the surgeon to decide 4 EDITORIAL the risk/beneft ratio before precautions. Provisions may help reduce implanting a lens in a patient 38 MARKETPLACE vision health inequalities with any of the conditions described in the Directions for Use labeling. Caution should be used prior to lens encapsulation to avoid lens decentrations or dislocations. © 2013 Novartis 2/13 NIQ13007JAD magentablackcyanyellow ES390079_OT021514_003.pgs 02.15.2014 03:18 ADV 4 editorial FEBRUARY 15, 2014 :: Ophthalmology Times FEBRUARY 15, 2014 ◾ VOL. 39, NO. 4 CONTENT Chief Medical Editor Peter J. McDonnell, MD Group Content Director Mark L. Dlugoss [email protected] 440/891-2703 Content Channel Director Sheryl Stevenson [email protected] 440/891-2625 Content Specialist Rose Schneider [email protected] 440/891-2707 ‘Best’ ways to die? Group Art Director Robert McGarr Art Director Nicole Davis-Slocum Anterior Segment Techniques Ernest W. Kornmehl, MD Cataract Corner Richard S. Hoffman, MD and Mark Packer, MD Two ophthalmologists go for a walk and contemplate death coding.doc L. Neal Freeman, MD, MBA Money Matters John J. Grande, Traudy F. Grande, and John S. Grande, CFPs® Neuro-Ophthalmology Andrew G. Lee, MD “Certainly,” he replied. “And will you do the Ophthalmic Heritage Norman B. Medow, MD By Peter J. McDonnell, MD same for mine?” Panretinal View Allen C. Ho, MD Plastics Pearls Richard Anderson, MD “Of course,” I said. Tech Talk H. Jay Wisnicki, MD director of the Wilmer Eye Institute, Uveitis Update Emmett T. Cunningham Jr., MD, PhD, MPH Johns Hopkins University School of What’s New at the AAO John Gallagher Medicine, Baltimore, and chief medical GOOD AND BAD WAYS PUBLISHING/ADVERTISING Executive Vice President Georgiann DeCenzo editor of Ophthalmology Times. We then contemplated that if doctors really do [email protected] 440/891-2778 die better than other people, what would be the VP, Group Publisher Ken Sylvia [email protected] 732/346-3017 He can be reached at 727 Maumenee Building better and worse ways. Our list of good and bad Group Publisher Leonardo Avila [email protected] 302/239-5665 600 N. Wolfe St. Baltimore, MD 21287-9278 ways to “buy the farm” included: Associate Publisher Erin Schlussel [email protected] 215/886-3804 Phone: 443/287-1511 Fax: 443/287-1514 National Account Manager Rebecca A. Hussain [email protected] 415/932-6332 E-mail: [email protected] > Being bored to death listening to billing and Vice President Healthcare Technology Sales Drew DeSarle [email protected] 440/826-2848 coding experts. (Bad way to die.) Account Manager, Classif ed/Display Advertising Karen Gerome > [email protected] 440/891-2670 “The fear of death follows from the fear of life. A Being annoyed to death by the transition to Account Manager, Recruitment Advertising Christina Adkins [email protected] 440/891-2762 man who lives fully is prepared to die at any time.” ICD-10. (Even worse.) Account Manager, Recruitment Advertising Joanna Shippoli —Mark Twain > Death from laughing. (This has been docu- [email protected] 440/891-2615 Business Director, eMedia Don Berman mented to occur, and strikes me as a relatively [email protected] 212/951-6745 Director, Sales Data Gail Kaye A RECENT ARTICLE in The New York good way to go.) Sales Support Hannah Curis Reprints 877-652-5295 ext. 121 / [email protected] Times1 suggests that physicians—because we > Death from embarrassment. (Although I fre- Outside US, UK, direct dial: 281-419-5725. Ext. 121 List Account Executive Renée Schuster understand the implications of a serious illness quently hear people say they were so embar- [email protected] 440/891-2613 Permissions/International Licensing Maureen Cannon diagnosis and the implications of treatment rassed they nearly died, I am not aware of this [email protected] 440/891-2742 and associated morbidity—die “better” than
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