IOL Selection for the Weakened
Capsular Bag
Devices designed to help stabilize the loosened capsular bag during phacoemulsification include (1) capsular tension rings (CTRs; Morcher GmbH, Stuttgart, Germany [distributed in the US by FCI Ophthalmics, Inc., Marshfield Hills, MA], and OPHTEC, Groningen, the Netherlands), (2) the Ahmed capsular tension segment (Morcher GmbH), and (3) capsule retractors such as the Mackool Cataract Support System (Duckworth & Kent Ltd., Hertfordshire, England, and Impex, Staten Island, NY). ...(full story)

Radial Rhexis Tear or Sulcus Implantation
The goal of cataract surgery is to achieve 100% capsular bag placement of the IOL in the setting of an intact continuous curvilinear capsulorhexis (CCC) and posterior capsule. Although a laudable aim, cataract surgeons sometimes fall short. Knowing how to compensate for complications related to suboptimal surgical anatomy is essential to providing our patients with optimal outcomes....(full story)

CCC, PCCC, or Membrane Capture
IThe objectives of IOL implantation are (1) a centered lens, (2) capsular fixation, and (3) a barrier to vitreous migration. In the absence of bag fixation, these objectives may be achieved by optic capture using either anterior continuous curvilinear capsulorhexis (CCC) capture, posterior CCC (PCCC) capture, or capsular membrane capture.

An absence of bag fixation can occur at any stage of primary cataract surgery (Table 1) and is almost certain to occur in secondary IOL surgery, such as during removal and replacement, repositioning, or secondary IOL placement after extracapsular cataract extraction (Table 2). The surgeon usually cannot reopen a fused capsular bag for bag fixation of an IOL. He may remove a defective IOL from a fused capsular bag by sliding the loops out of the membrane; if this is not possible, he may cut off the loops and leave them in the membrane. He may use a similar removal technique for an eccentric IOL with only one loop in the bag.
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Sclerally Sutured PCIOLs: Part I
Most cataract surgery performed today in the US is extracapsular cataract extraction with phacoemulsification and the implantation of a posterior chamber IOL (PCIOL). When an intact posterior capsule is present, almost all surgeons favor in-the-bag placement of a PCIOL. In the absence of capsular support, however, the choice of lens type and the technique used to secure it in the eye is much more controversial.
...(full story)

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May 2004

IOL Contingency Plans—Are You Prepared?
One of the most interesting and controversial topics in cataract surgery is that of IOL selection and fixation in the absence of optimal capsular bag support. We have therefore chosen this topic as the focus of our annual cataract complications issue.
Twenty years ago, there was not much to debate. Following a can-opener anterior capsulotomy, if posterior capsular rupture precluded sulcus implantation, we usually implanted an ACIOL. The increasing incidence of ACIOL complications—usually caused by sizing problems, movement, and closed-loop haptics—led to the development of techniques to suture PCIOLs to the sclera.
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May 2004 Supplement

Federal Circuit Court Confirms That Nidek Did Not Infringe Alcon’s Patents
The US Court of Appeals for the Federal Circuit upheld a lower court’s decision that Nidek did not infringe two patents owned by Summit Technologies, Inc., now known as Alcon Laboratories, Inc. (Fort Worth, TX). The Court of Appeals affirmed the District Court’s December posttrial order overturning a jury’s determination that Nidek was infringing Alcon’s patents covering broad-beam excimer laser technology....

Medicare Reimbursement for Optical Biometry Increases By More Than 33%
The Centers for Medicare and Medicaid Services announced changes to the 2004 Physician Fee Schedule for optical biometry that will allow practitioners to bill professional services as a unilateral service under CPT code 92136. This decision effectively increases the potential reimbursement for optical biometry by more than 33%.

This change to the fee schedule, active as of April 5, benefits physicians utilizing the IOLMaster optical coherence biometry (Carl Zeiss Meditec Inc., Dublin, CA) for their preoperative measurements.

Allergan Joins Forces with Lupin to Promote Zymar
Allergan, Inc. (Santa Ana, CA), entered into an accord with Lupin Limited’s (Mumbai, India) wholly owned subsidiary Lupin Pharmaceuticals, Inc., to promote Zymar 0.3% in the pediatric specialty area. Under the terms of the accord, Lupin Pharmaceuticals’ pediatric sales forces will promote the fourth-generation fluoroquinolone to high-volume pediatric prescribers.

AMO Launches Extended Low-Diopter Ranges of Its ClariFlex With OptiEdge
Advanced Medical Optics, Inc. (Santa Ana, CA), announced the launch of extended low-diopter ranges of its ClariFlex with OptiEdge. The ClariFlex is now available in dioptric ranges from -10.00 D to +5.50 D, in 0.50-D increments. The new range will allow surgeons to extend the benefits of the OptiEdge design to highly myopic patients.

According to the company, low-diopter ranges of its acrylic Sensar with OptiEdge will be coming soon.

INTRALASE FS Laser Receives CE Mark
IntraLase Corp. (Irvine, CA), announced it has received the CE Mark for its INTRALASE FS laser. This laser has also received certification of registration that its Quality Management System meets the requirements of ISO 13485.
IntraLase has placed a total of 120 lasers globally in countries including Canada, Japan, Korea, Malaysia, Mexico, and Israel. In Italy, Lucio Buratto, MD, received the first laser in the European Community.

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