Traditional diffractive multifocal lens implants are sometimes associated with unacceptably high levels of optical aberrations, haloes in the vision, and glare. Some authorities would actually not recommend diffractive multifocal implants in individuals needing to drive at night regularly, because of the potential for glare from oncoming headlights. Accordingly the lens technology companies developed Extended Depth… Read More
Deferring surgery for epiretinal membrane
With UK optometrists purchasing OCT scanners at pace, early and asymptomatic epiretinal membrane (ERM) is increasingly referred into ophthalmology, as it is technically an abnormal finding. This retrospective study looked at just over 400 patients with ERM and analysed outcomes of those who underwent immediate surgery, compared to those who were observed. The study results… Read More
Systemic adverse events from eye injections for diabetic macular swelling
This large American claims database based retrospective cohort study examined over 23,000 patients receiving antiVEGF injections for diabetic macular swelling and reassuringly found no increased risk of stroke, heart attack or major bleeding events, when compared with patients receiving macular laser therapy for the same condition: https://pubmed.ncbi.nlm.nih.gov/30292542/ However this study is based on US patients… Read More
Review of laser-assisted cataract surgery published (Dec 2019)
This month, a review paper has been published in the European Journal of Ophthalmology authored by specialists at multiple central London teaching hospitals. This paper has systematically looked at the published evidence base to date for laser-assisted cataract surgery. Upon reviewing 121 suitable publications, the authors have concluded that “the current clinical outcomes of femtosecond… Read More
Femtosecond laser-assisted cataract surgery
Earlier this year, a randomised controlled clinical trial was published from the group at St Thomas’ Hospital in London, directly comparing outcomes of conventional cataract surgery with laser-assisted cataract surgery. With 200 eyes in each trial group, the study found virtually no meaningful differences in outcome for the two groups in terms of level of… Read More
Routine OCT scanning prior to cataract surgery
Here is an interesting write-up of a study from Israel that was presented at this year’s American Academy annual meeting. Of the 226 patients (mean age 73 years) referred, 40% of the OCT scans were classified as abnormal, with macular degeneration, epiretinal membrane, and vitreomacular traction all represented. Apparently, some 18 of these eyes had… Read More
Anti-VEGF injections for proliferative diabetic retinopathy
Retinal specialists knew that this would be on the cards at some point, but managing proliferative diabetic retinopathy (PDR) with regular intravitreal injections is not standard practice in the UK. This is perhaps due to cost, service pressures, or the fear of non-attendance or service-initiated re-schedulings causing re-proliferation at the retina and subsequent complications such… Read More
Outcomes of laser-assisted vs manual cataract surgery
Laser-assisted cataract surgery has emerged as an alternative to traditional (manual) cataract surgery in recent years, but several studies have failed to provide evidence of major advantages of the technology, while others have demonstrated that laser-assisted cataract surgery may actually increase complication rates. This recent, large, single-centre study examined visual and refractive outcomes on around… Read More
New anti-VEGF agent for macular degeneration shows promise
Phase 2 studies of brolucizumab show similar efficacy to aflibercept (Eylea) for wet age-related macular degeneration (AMD) and the drug is now advancing to Phase 3 trials. Wet AMD is becoming more prevalent and the higher the number of treatment options, the better. What is interesting is that the brolucizumab group in the study may… Read More
Laser assisted cataract surgery
This meta-analysis of over 14,000 eyes, published in late 2016, found no significant differences in visual outcome between conventional cataract surgery and femtosecond laser-assisted cataract surgery: http://dx.doi.org/10.1016/j.ophtha.2016.07.005
