Treating Epithelial Ingrowth with the YAG Laser

Jorge L. Alió, MD described the use of the YAG laser to treat epithelial ingrowth after LASIK as an alternative to flap lifts in a recent issue of Refractive Eyecare. Early treatment of mild-to-moderate epithelial ingrowth with the Nd:YAG laser promises a simple way to eliminate a vexing problem and, possibly, prevent the development of more serious problems.
Instead of lifting the LASIK flap, refractive surgeons can treat most moderate epithelial ingrowth and restore patients’ lost visual acuity with a laser commonly used after cataract surgery. This low-energy, effective procedure uses the workhorse of ophthalmic lasers to spare patients more invasive surgery and avoid the risks of further complications from a flap lift

Thin Corneas Not a Risk for LASIK

Contrary to the assumption that eyes with thin corneas are poor candidates for LASIK because they are at increased risk of developing postoperative ectasia, scientific evidence fails to support preoperative central corneal thickness (CCT) as an independent risk factor for this complication, said William B. Trattler, MD, at the annual meeting of the American Academy of Ophthalmology. Individuals with thin corneas, however, are at risk for ectasia if an abnormality such as forme fruste keratoconus (FFKC) is found during preoperative topographic analysis, he said.
Time and time again I have seen patients told they are not a candidate for LASIK because of thin corneas. There are multiple studies that show that thin corneas are not an independent risk factor for LASIK and this is just one more report confirming this.

Outdoor Activities Decrease the Risk of Myopia

Spending 2 to 3 hours a day outdoors can significantly lower a child’s risk of developing myopia, according to a new study.
A child’s chances of becoming nearsighted, if he or she has two nearsighted parents, are about six in 10 for children who spend 0 to 5 hours outside a week, but the risk drops to two in 10 when outdoor time exceeds 14 hours a week, according to researchers.
Researchers also said that the critical factor for reducing development of myopia in children seems to be total time spent outdoors; both active and passive outdoor activities equally protected child’s vision.

Botox

Speaking of newer cosmetic uses of drugs, many readers may not be aware that the some of the original uses of Botox also were in ophthalmology. The muscle paralyzing properties were and continue to be used in blepharospasm, a benign but very disturbing forceful lid closing condition. Patients who suffer from blepharospasm experience uncontrolled forceful lid closure/spasms that can be quite debilitating. The injection of botox in and around the eyelids can give relief for approximately 6 months. Now the most common use of Botox is the relaxation of facial wrinkles. Newer indications continue to evolve and Botox has been used for relief of other muscle spasms and contractions, strabismus, severe sweating (hyperhidrosis), and headaches.

New Drug for Longer Lashes

Doctors are always looking for new uses for existing drugs. What started out as a medication for a very serious eye problem is now making waves as the latest thing in cosmetics. It can make eyelashes longer & thicker.
Latisse contains bimatoprost, a compound from a glaucoma drug called Lumigan. It binds to receptors in the eyelashes that may be involved in the development and re-growth of hair follicles. Allergan has used bimatoprost since 2001 in Lumigan.
The company began studying the potential of using a lower dose of topical bimatoprost to stimulate eyelash growth after Lumigan users developed unusually lush lashes. It's specifically being marketed as a once-a-day medication to treat eyelash hypotrichosis, or lack of hair growth.
Latisse pushes more follicles into the growth phase, and lengthens the time they spend there. But you do need to be careful applying Latisse.
If it gets on other skin, it can cause discoloration.
And some users in the trial reported redness, or itching of the eyes.
The drug's effect isn't immediate. According to manufacturer Allergan, the drug usually brings results two to four months after users start it.
Latisse has been on the market for about two weeks now... And it's generated a lot of interest.
But it isn't cheap. It costs about $240 dollars for a year's supply. And you have to keep using it to keep your lashes full.
It's possible that the drug may also spur eyebrow and scalp hair growth, doctors told the Wall Street Journal. But Allergan spokesperson Heather Katt says the company hasn't explored using Latisse for those purposes

New Bifocal Intraocular Lens

One of the main complaints that patients have had with the Alcon ReStor Intraocular Lens was the close working distance and poor intermediate vision found with this lens. The near focal point of this implant is around 13 inches which forced patients to hold reading material much closer than they may have been accustomed to. This lens also did not perform well at the computer or when used for other intermediate tasks such as looking at prices on store shelves etc. Alcon has addressed these problems with a new model ReStor which has a near focal length of approximately 16 inches. In the recent FDA clinical trial of the AcrySof IQ Restor IOL +3.0 D (Alcon Laboratories, Inc., Fort Worth, TX), patients achieved the same superb distance and near vision with this lens as those who received the AcrySof IQ Restor +4.0 D lens (Alcon Laboratories, Inc.). As an added benefit, compared with the +4.0 D model, the +3.0 D design dramatically improved patients' intermediate vision at 50, 60, and 70 cm .

Intacs for Keratoconus

Keratoconus is a corneal disorder in which progressive astigmatism develops, probably because of weakening. Patients who suffer from keratoconus suffer from corneal thinning and vision loss. Ultimately patients may require a corneal transplant. Recently, surgeons have begun to implant plastic inserts (Intacs) to bolster the cornea and delay, perhaps indefinitely, the need for a corneal transplant. I have implanted Intacs in several keratoconus patients and have been impressed with the results. Patients have exhibited a reversal in their astigmatism and often show an improvement in best corrected vision. the original application for Intacs was for the correction of nearsightedness. Popularity has waned as the LASIK procedure improved but Intacs have enjoyed a resurrgence in interest for their use in keratoconus. For more information go to www.intacsforkeratoconus.com.