Laser for cataract & corneal procedures gets 510(k) clearance

Posted on March 28, 2013 by Laser Locators

The U.S. Food and Drug Administration granted 510(k) clearance to the Victus femtosecond laser platform, designed to be used in both cataract and corneal procedures, according to a news release from Bausch + Lomb and Technolas Perfect Vision.

The platform is cleared for creation of a corneal flap for LASIK surgery or other treatment requiring initial lamellar resection of the cornea and anterior capsulotomy during cataract surgery, the release said.

“Cataract surgery, in its traditional form, delivers excellent results, and is arguably one of the safest and most successful surgical procedures performed anywhere in the body. The opportunity to further improve the outcomes of cataract surgery is something I am proud to be a part of,” Steven J. Dell, MD, of Dell Laser Consultants in Austin, Texas, said in the release.

The Victus platform may offer greater precision compared to manual cataract surgery techniques by allowing for more precise, controllable and centered capsulotomy, according to the release.

“The Victus platform represents a major advancement for ophthalmic surgeons that can potentially enhance patient outcomes,” Kristian Hohla, PhD, chief executive officer of Technolas, said in the release. “We look forward to the continued commercialization of the technology around the world, so that ophthalmic surgeons can experience its potential for themselves.”

The platform received CE mark approval in Europe in December and is now available for shipment in the United States. The companies plan to submit additional indications to the FDA.

At Laser Locators we carry the top name surgical and diagnostic ophthalmic equipment manufacturers you can trust, like Acon, Nidek, Lumenis and more for preforming all of your precise ophthalmic procedures. Contact us at www.laserlocators.com or call 1-877-924-2020 and let one of our expert equipment locators help you today.

Getting the Most out of Three IOLs

Posted on February 22, 2013 by Laser Locators

“The aspheric design of this multifocal IOL enhances patients’ outcomes”, says Elizabeth A. Davis, MD. “There are a number of different IOLs to choose from to achieve the best outcome for patients today. Presbyopic correction lenses are now available and with good results. In many cases, surgeons prefer the Tecnis Multifocal IOL (Abbott Medical Optics Inc. [AMO]) based on their design and positive outcomes.”

In assessing any IOL, you must consider several factors: ease of implantation, predictability of refractive outcome, quality of vision, range of focus (spectacle independence), patients’ satisfaction, side effects, and long-term stability.

The Tecnis Multifocal IOL is based on an aspheric optic design meant to reduce the spherical aberration of an average cornea to zero. The Tecnis Multifocal has a full-diffractive posterior surface, which makes the diffractive optics pupil independent for optimal image quality at all distances under any lighting condition. The optic is made of acrylic and comes in both a one- and three-piece design. The frosted edge also minimizes edge glare.

Experience With The Lens

In a clinical trial, 94.6{0730eed075b45d9e50c00d6cd42dd08773e0164f29a45151808bf89051290974} of subjects implanted bilaterally with the lens reported being satisfied with their vision. Also at 1 year, 92.1{0730eed075b45d9e50c00d6cd42dd08773e0164f29a45151808bf89051290974} of the subjects had 20/25 or better distance UCVA and saw 20/32 or better at near with distance correction in place. More than 86{0730eed075b45d9e50c00d6cd42dd08773e0164f29a45151808bf89051290974} of subjects reported never wearing glasses, and slightly less than 90{0730eed075b45d9e50c00d6cd42dd08773e0164f29a45151808bf89051290974} were able to function comfortably without glasses at all distances (96.9{0730eed075b45d9e50c00d6cd42dd08773e0164f29a45151808bf89051290974} at near, 89.7{0730eed075b45d9e50c00d6cd42dd08773e0164f29a45151808bf89051290974} at intermediate, and 95.5{0730eed075b45d9e50c00d6cd42dd08773e0164f29a45151808bf89051290974} at distance).Only 1{0730eed075b45d9e50c00d6cd42dd08773e0164f29a45151808bf89051290974} always wore glasses.

All multifocal IOLs inherently reduce contrast and induce some amount of glare and halos, it is important to inform all patients that they should anticipate such side effects. Achieving optimal refractive outcomes with the Tecnis Multifocal IOL requires careful preoperative, intraoperative, and postoperative care. Preoperative preparation requires optimization of the ocular surface, a thorough examination to exclude patients with conditions that would preclude good outcomes, and precise biometry and IOL calculations.

To achieve the best results with the lens, it is important to choose appropriate candidates. Certainly, patients should desire reduced dependence on glasses and contact lenses. They should understand not only the risks of cataract surgery in general but the potential side effects of the lens, including reduced contrast, glare, and halos. Either patients should have minimal corneal astigmatism, or the surgeon should have an appropriate method to manage astigmatism. Accurate preoperative keratometric and biometric measurements are critical, and ocular surface disease must be aggressively treated.

Presbyopia-correcting IOLs are one of the most important transforming factors in the practice of anterior segment ophthalmology, and the AcrySof IQ Restor (Alcon Laboratories, Inc.) diffractive multifocal lens is the most commonly implanted presbyopia-correcting IOL in the United States. This technology offers patients visual rehabilitation for functional distance, reading, and intermediate vision. The surgeon’s selection of patients, meticulous attention to detail, and optimization of postoperative results are the keys to successful outcomes with this lens.

Recent advances in technology with laser cataract surgery may permit greater centration and consistent sizing of the capsulorhexis that could enhance refractive outcomes with presbyopia-correcting IOLs. Accurate biometry with the IOLMaster (Carl Zeiss Meditec, Inc.) or the Lenstar LS 900 (Haag-Streit AG) and control of astigmatism are also essential to maximizing outcomes. Because the lens constant must be carefully personalized to the individual surgeon, tracking postoperative results is imperative to refine surgical outcomes.

Patients are incredibly sensitive to small refractive errors with presbyopia-correcting IOLs, so surgeons must be willing and able to treat them. Astigmatism of greater than 0.50 D in a symptomatic patient requires surgical planning.

With attention to residual refractive error, the ocular surface,2 cystoid macular edema, and the posterior capsule, surgeons can improve appropriate patients’ quality of vision with the AcrySof IQ Restor IOL. The technology has enhanced the quality of life of many pseudophakic patients by reducing or eliminating their need for spectacles. As physicians’ comfort with multifocal lenses improves in the coming years, these IOLs should become more popular, both with cataract and refractive surgeons and their patients.

OCT – Now A Tool For The Comprehensive Ophthalmologist

Posted on January 30, 2013 by Laser Locators

Ocular Surgery News U.S. Edition, June 10, 2012

According to Richard L. Lindstrom, MD optical coherence tomography has moved from being a tool primarily utilized by the retina subspecialist to one increasingly present in the comprehensive ophthalmologist’s office.

Time-domain OCT (TD-OCT) is a non-contact test that can be done by an ophthalmic technician to image the optic nerve, macula or retina. The OCT (SD-OCT), which is a higher-speed, higher-definition instrument that gives even better images, allowing resolution that includes individual cell layers including the retinal pigment epithelium (RPE), photoreceptors, as well as a larger area of the retina or macula. The newest SD-OCT algorithms even allow 3-D reconstructions.

New strides are occurring in TD-OCT and SD-OCT to interpret retinal and macular thickness, RPE elevation and drusen size/volume in microns. In the future, it is anticipated that even cellular metabolic rates will be measurable. And similar technology is being applied in the anterior segment, promising great advances in diagnostic capability.

The classical abnormalities in dry age–related macular degeneration include drusen formation, pigment dispersion/clumping and focal atrophy of the RPE. Each of these findings can be observed, documented and measured with OCT. In addition, with SD-OCT, drusen size and volume can be measured, and the actual RPE cells at the edge of an area of geographic atrophy can be seen, allowing one to measure the rate of progression. Photoreceptor atrophy and changes in the choriocapillaris often accompany these changes and can be visualized. In wet AMD, one can visualize the area where abnormal vessels penetrate Bruch’s membrane, causing fluid or blood to accumulate under the RPE and resulting in a pigment epithelial detachment (PED) or fluid accumulation in the subretinal space or within the retina. The size and volume of a PED can be measured, as can the overlying retinal thickness, potentially allowing earlier diagnosis and, when treated, monitoring of the response to therapy.

For the cataract surgeon, preoperative screening allows the detection of epiretinal membranes, vitreomacular traction syndrome, diabetic macular edema and rarer macular abnormalities such as macular schisis, resulting in proper preoperative, intraoperative and postoperative therapy and timely patient counseling. Postoperative macular thickness is a very useful tool in the diagnosis of postsurgical cystoid macular edema and is also helpful in monitoring the response to therapy. TD-OCT imaging and SD-OCT imaging of the optic nerve head are becoming a critical component in the early diagnosis of glaucoma and in monitoring the patient for early signs of progression.

Ophthalmology has always been heavily dependent on technology to enhance the diagnostic and treatment acumen of the clinician, and despite the cost of OCT acquisition in the face of increasing economic pressure; it is difficult to imagine a busy ophthalmic practice without OCT or SD-OCT in 5 years.

Twitter and Healthcare?

Posted on November 4, 2012 by Laser Locators

The popular and growing micro-blogging platform famous for its 140- word character limit has been ubiquitous these days. Celebrities are all over it with mass followers, commercials and televised events give hashtag words to use when tweeting about their products or events. Even the White House maintains an active Twitter account, but how is Twitter appropriate for a professional field such as medical, and how can physicians and other health care providers use it professionally?

Twitter is an excellent source for gathering the latest news and developments on any topic you find relevant and interesting. In addition to following large news outlets on Twitter, you can use it to find others in your field who are informed and active on Twitter. If you are just getting started consider, websites such as www.twitterdoctors.net , they curate a regularly updated list of the most influential doctors on Twitter.

Whether you are sharing information with the general public or exchanging thoughts and opinions with colleagues in your field, Twitter allows you to position yourself as an informed expert by sharing information. In this manner, you can also stay abreast of breaking news and learn from others’ shared perspectives.

If used correctly, Twitter can be effective at promoting your practice or office. Tweet about upcoming events or specials, Twitter-only discounts, or to promote your website or blog. The key to a successful social media account is content that users find valuable. Using Twitter to share general health tips and news related to your specialty is a great way to provide helpful information, establish yourself as an expert in your field with a broad online audience, and cultivate a following of interested, attentive followers.

When it comes to “sharing” a professional in the healthcare industry should always be discreet. Twitter should never be used diagnose conditions or betray your patients’ privacy. Yes, it is possible to share too much and identify patients, even inadvertently. You must also keep in mind that, unlike direct messages, Twitter replies and re-tweets are publicly viewable and searchable.

Shama Kabani is a best-selling author, speaker, and president of The Marketing Zen Group in Dallas. Ms. Kabani may be reached at shama@marketingzen.com or via Twitter @Shama.

Relief for Chronic Dry Eyes

Posted on October 22, 2012 by Laser Locators

Dry Eye Syndrome occurs when the normal flow of tears over the eyes is interrupted, or the tear film is abnormal and there are insufficient tears to lubricate the eye. Dry eye syndrome is a chronic condition and can get worse with age. You can relieve the symptoms, but not cure the original cause.

Artificial Tears

Artificial tear lubricants or in some cases blocking the tear ducts will concentrate the limited tears that are available. Artificial tears are eye drops that can be purchased over the counter to increase the amount of tears in the eye and improve the symptoms of the condition. There are many types available–from eye drops to gel formulations. The gel formulations can cause blurring of the vision but relief from the symptoms may last longer. Preservative-free eye drop formulations are popular because they have fewer additvives and may cause less irritation especially if the eye drops are used regularly.

Anti-inflammatory Eye Drops

Restasis eye drops are an ocular cyclosporine formulation that helps the eye increase tear production. This medication is only available by a prescription from an eye doctor. In more severe cases, some doctors may prescribe a short course of steroid eye drops to treat dry eye.

Punctal Occlusion

An eye doctor can also insert small silicone plugs into the drainage channels in the upper and lower eyelids to prevent the tears that are present in the eye from draining out of the eye. These plugs are temporary and can fall out over time. A minor surgical procedure can also be done in the office to permanently close the tear ducts.

Lacrisert

A small insert called Lacricert that is filled with medication (hydroxypropyl cellulose) can also be inserted into the tear duct. The eye medication is continually released from the insert during the day and improves the tear film of the eye. The insert is replaced daily and is applied by the patient at home. Care must be taken with insertion to prevent eye injury.

Your eye doctor can determine your best course of treatment for your particular case. With these simple and safe options available, you do not have to suffer with chronic dry eyes anymore.