Blog

Blogbeiträge der letzten Wochen

23.05.2024

The impact of the COVID-19 pandemic on refractive surgery

Since the coronavirus pandemic in 2020 at the latest, medical protective measures such as regularly disinfecting hands or wearing a mask when you have a cold have become part of everyday life for many people. Spectacle wearers in particular are faced with the problem of fogged-up glasses. Contact lens wearers are also increasingly struggling with dry eyes due to the air escaping from under the mask.

Thanks to medical advances, refractive surgery now offers many patients a long-term solution for freedom from glasses. In addition to classic Femto-Lasik, there is also the option of implanting an ICL (anterior chamber lens) or a refractive lens exchange, which is particularly suitable for patients with thin corneas.

The current social changes in terms of individual health awareness raise the question of whether refractive services for freedom from spectacles will be used more frequently after the pandemic.

The paper by Kermani et al. deals with the changes that the virus has brought to society as a whole and, as a consequence, to refractive surgery. Kermani et al. state that since the beginning of the pandemic, feelings of anxiety in connection with social distancing have become more widespread in society. As a result, there has been an increase in personal protective measures, such as wearing masks or face coverings. Meanwhile, the European COVID-19 Cataract Group (EUROCOVCAT) reports an increase in demand for corneal and refractive cataract surgery, which initially posed a major challenge for European ophthalmologists. Specifically, an increase of 25% (as of 2021) was reported compared to the same period in the previous year for patients presenting for refractive surgery for the first time.

At this point, the question arises as to whether this is due to a change in health awareness and the increased use of visual aids. However, this must be countered by the fact that, according to EUROCOVCAT, fewer procedures were performed during the pandemic that now need to be repeated.

The paper by Kermani et al. deals with the changes that the virus has brought to society as a whole and, as a consequence, to refractive surgery. Kermani et al. state that since the beginning of the pandemic, feelings of anxiety in connection with social distancing have become more widespread in society. As a result, there has been an increase in personal protective measures, such as wearing masks or face coverings. Meanwhile, the European COVID-19 Cataract Group (EUROCOVCAT) reports an increase in demand for corneal and refractive cataract surgery, which initially posed a major challenge for European ophthalmologists. Specifically, an increase of 25% (as of 2021) was reported compared to the same period in the previous year for patients presenting for refractive surgery for the first time.

At this point, the question arises as to whether this is due to a change in health awareness and the increased use of visual aids. However, this must be countered by the fact that, according to EUROCOVCAT, fewer procedures were performed during the pandemic that now need to be repeated.

The study by Kermani et al. also points out that the demand for refractive surgery has been increasing for years and that the pandemic has only slightly reduced this demand.

16.05.2023

The development of the femtosecond laser

The femtosecond laser is currently used in various ophthalmic surgery procedures to achieve more precise results than would be possible using the "classic" surgical scalpel.

But how did this come about and how has laser technology developed in recent years?

The femtosecond laser was first used in ophthalmology for cataract surgery in the early 2000s. Initially, the focus was on evaluating its efficacy and safety in creating precise capsulotomies and lens fragmentation during cataract surgery. Over the years, the technology has evolved. Today, the femtosecond laser is used in refractive surgery as well as in cataract surgery and subsequent post-cataract treatment, known as capsulotomy.

One of the main advantages of femtosecond laser-assisted cataract surgery is the precision it offers when fragmenting the body's own lens during cataract surgery or creating a flap during LASIK. According to a study (Dick & Schultz, 2017; Titiyal et al., 2016 see list of sources below the article), this is particularly advantageous in patients with a low preoperative endothelial cell count.

Particularly in the field of cataract surgery, femtosecond lasers have been found to offer better wound architecture and lead to less endothelial cell loss compared to conventional cataract surgery. Femto lasers also offer the ability to customize the size and position of the capsulometry for patients with zonular weakness, resulting in more precise outcomes.

As a result, the femto laser has become increasingly popular in cataract surgery among ophthalmic surgeons due to its higher precision and reproducibility as well as the potential for better refractive results.

In summary, the development and integration of the femtosecond laser has revolutionized the field of ophthalmic surgery. In the past, the laser has helped to improve the precision, safety and patient satisfaction of ophthalmic surgery.

09.05.2024

The treatment of glaucoma - how has the medical standard changed in recent years?

In recent years, advances in the treatment of glaucoma have reshaped the standard of care for this disease. One significant advance has been the integration of optical coherence tomography (OCTA) into multimodality imaging to assess various retinal conditions (Spaide et al., 2018). OCTA technology has enabled automatic quantification of ocular structures and detection of subtle changes over time, revolutionizing glaucoma management. In addition, spectral-domain optical coherence tomography (SD-OCT) has greatly improved the ability to detect glaucoma progression, allowing for more precise monitoring and adjustment of treatment (Abe et al., 2015).

02.05.2024

Visual prosthesis for a blind person - intracortical visual prosthesis successfully implanted

The Intracortical Visual Prosthesis (ICVP) is a wireless brain implant to restore vision in blind people. After successful testing on one patient over a two-year period, it has been reported that the prosthesis bypasses the optic nerve and sends images directly to the brain to provide artificial vision. The system consists of 25 miniaturized wireless stimulators with a total of 400 electrodes that are permanently implanted. The clinical trial demonstrated improved navigation ability and the ability to perform basic visually guided tasks.

25.04.2024

What effect does LASIK have on dry eyes?

Dry eyes are a widespread symptom in the population. In particular, people who work a lot in front of a screen or take too few breaks often have itchy or irritated eyes. This raises the question of the extent to which opting for LASIK treatment can have an impact on dry eye symptoms.

18.04.2024

Advances in refractive surgery in recent years

Refractive surgery has evolved significantly in recent years, with a focus on improving outcomes and expanding treatment options. Recent developments in refractive surgery have addressed innovative strategies, including preoperative assessment using machine learning and artificial intelligence and improvements in intraocular lens implants for more precise correction of refractive errors. All advances are aimed at providing patients with more personalized and efficient solutions for their refractive errors.

28.03.2023

The quality of life of myopia patients - contact lens and spectacle wearers vs. correction by refractive surgery

The study by Shams et al. compares the quality of life of people with myopia who have undergone refractive surgery with that of spectacle or contact lens wearers and emmetropes. 240 students aged 18-30 years were studied using quality of life questionnaires. The participants were divided into two groups: Myopic individuals with visual aids, those with refractive surgery. The results were also compared with the responses of people with normal vision. Data was collected through observation, interviews and questionnaires.

21.03.2024

Preventing blindness? New insights into the microbial secret of inherited eye diseases

Research by scientists at UCL and Moorfields University has uncovered an intriguing link between gut bacteria and inherited eye diseases that could have potentially revolutionaryimplications for preventing blindness. This groundbreaking study, published in the journal Cell and led by researchers in China, focuses on the so-called CRB1 gene, which is expressed in the retina and is crucial for regulating the blood-retinal barrier. Mutations in this gene are often associated with inherited eye diseases such as Leber's congenital amaurosis(LCA) and retinitis pigmentosa (RP).

14.03.2024

Digital patient education in ophthalmology

Patients are informed about the expected results, advantages and disadvantages of surgical procedures during a medical consultation. Due to a lack of time, ambiguities can arise here. If patients' questions are not answered adequately, this quickly leads to anxiety and reduces compliance with pre- and post-operative care.

07.03.2024

Artificial intelligence in ophthalmology

AI-supported systems are already being used in many areastoday. In medicine artificial intelligence is already helping to evaluate diagnostic procedures and detect pathologies. The Cochrane Eyes and Vision Group has now conducted a study to investigate the extent to which AI has the potential to detectkeratoconus.

28.02.2024

Diabetic retinopathy: news from research

The University of Bristol in England has presented groundbreaking research findings that suggest a novel inhibitor could prevent the onset of microvascular diabetic complications, particularly eye and kidney disease. Previous treatments for patients with such complications failed to completely halt progression and often led to serious consequences such as blindness and kidney failure.

22.02.2024

Migraine and blood flow to the eye - is there a connection?

The results of a new study in the Journal of Head and Face Pain indicate a connection between migraine attacks with aura and the retina of the eye. The visual disturbances experienced by many migraine patients are therefore associated with circulatory disorders in the retina of the eye. Optical coherence tomography angiography makes it possible to record these disturbances, especially in migraine with aura compared to migraine without aura. The study of 37 patients with aura and 30 without aura showed that the "Vessel Flux Index" (VFI), a measure of recognizable vessels in optical coherence tomography angiography, was already 13% lower in patients with aura during the pain-free interval. In addition, during attacks, patients with aura showed more uniform boundaries of the recess. Interestingly, in patients with unilateral headache, blood flow in the eye on the same side as the headache was better during the attack than on the opposite side.

16.02.2024

Progress in research - new therapy embraces new chances

A complete loss of sight is usually irreversible. Will it be possible to restore sight to blind people in the future?

Research into restoring sight in blind people has made significant progress. Botond Roska from the Institute of Molecular and Clinical Ophthalmology in Basel has developed a pioneering method to restore the function of defective sensory cells in the retina. By genetically modifying retinal cells, Roska was able to introduce genes in a targeted manner using harmless viruses and thus restore vision in blind mice and human retinas. He has now been honoured with the Translational Neuroscience Prize from the Gertrud Reemtsma Foundation.

08.02.2024

Sicca symptoms

Dry heating air and a lot of screen time lead to irritated and itchy eyes for many people, especially in winter. For some patients, dry eyes are even a chronic problem that severely restricts their quality of life.

01.02.2024

Safe cataract operations: The femtosecond laser

The results of a new study on the safety of cataract surgery show that both femtosecond laser-assisted cataract surgery and standard surgery are both safe. The safety and efficacy of both methods were confirmed regardless of the surgical method chosen.

25.01.2024

Pandemie der Myopie

In their paper "The Myopia Pandemic", Omid Kermani and Arthur B. Cummings look at two studies that have researched the current state of global myopia figures, as well as future developments and possible approaches to improvement. The findings of a working group of doctors and scientists, the AAO's Task Force on Myopia, analysed scientific literature and showed that myopia (from -0.50 diopters) will increase from 22.9% of the world's population in 2020 to 49.8% in 2050. They speak of a "myopia pandemic".

18.01.2024

Global ophthalmological care - approaches for optimizing quality in developing countries

Cataract extraction is the most common eye surgery worldwide, but offers lower success rates in resource-poor regions. A 2017 survey of 20 low- and middle-income countries found that only 36.7% of operable cataracts were successfully operated on. This emphasises the need for improved cataract surgery coverage.

To address this problem, an increase in the number of trained ophthalmologists is required. The accessibility and quality of treatment must be improved.

11.01.2024

The EVO ICL - an alternative for patients with thin corneas?

Since the EVO ICL from STAAR Surgical received FDA approval in April 2022, many patients have already benefited from it. The EVO ICL offers an alternative for patients with a high degree of myopia or thin corneas who are not suitable for LASIK or PRK. The EVO ICL is a further development of the ICL that has been established for many years. Thanks to so-called EDOF optics, the EVO ICL has greater depth of field and is therefore particularly suitable for middle-aged patients who find working at a computer or reading increasingly difficult.

04.01.2024

Refractive surgery in children

With the current increase in myopia, the topic of refractive surgery in children and adolescents is becoming increasingly important. In expert circles, however, the underage patient group is often neglected. For this reason, Dr. Kermani conducted a survey among refractive surgery colleagues. The aim was to find out how often children and adolescents receive refractive surgery treatment, which operations are performed and what the treatment results are.

28.12.2023

Lessons learned: strategies to avoid common pitfalls

Ophthalmology is constantly changing. At the end of the year, it's time to look at past experiences from the past year and use them for continuous improvement to provide the best possible patient care.

The article "Lessons learned: strategies to avoid common pitfalls" by Mitchell Weikert in the current issue of EyeWorld illustrates how the industry benefits from past experiences and improves its standards. One focus is on lessons learned in the context of cataract surgery, where renowned specialists such as Dr. Rom Kandavel, Dr. Mitra Nejad and Dr. Amandeep Rai, FRCSC, provide valuable insights into individualizing the optimal timing of the procedure. Particular attention will be paid to the concept of patient-centered care, which provides for tailored decision-making for each individual patient.

21.12.2023

Lessons learned: strategies to avoid common pitfalls

Today, around 1.1 billion people worldwide have to live with untreated vision loss. 43 million of these people are blind. The main cause of this is an untreated cataract. It is striking that around 90% of these people live in low- or middle-income countries. The article "A Force for Good in Global Eye Care" discusses the challenges and progress in the field of visual health in sub-Saharan Africa and the efforts of organisations such as the Community Eye Health Institute (CEHI) and the European Society of Cataract and Refractive Surgeons (ESCRS) to meet this need.

15.12.2023

Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050

In a new study "Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050", Holden et al. found that the number of myopia patients worldwide will continue to increase in the future. While 1406 million people worldwide had to live with myopia in 2000, this figure had already risen to 1950 million by 2010. According to projections, this figure is expected to rise to 3361 million people by 2023. What is the reason for the drastic increase in the number of people affected?

30.11.2023

MEACO-MIOC 2023

The MEACO-MIOC Congress is a prestigious event focussing on ophthalmology in the Middle East and Africa. The congress brings together leading professionals, researchers, practitioners and industry experts in ophthalmology to discuss the latest developments, research findings and innovations in the field.

23.11.2023

Das erste transplantierte Auge

In his new article "Sehr her!" Jörg Zittlau reports on Aaron James, who survived a serious
electrical accident. He lost parts of his left arm, his nose, lips, parts of his chin and his left
eye. Under the direction of Dr Eduardo Rodriguez at NYU Langone Health in New York City,
he received the world's first facial transplant with a complete eye during a 21-hour procedure
in May 2023.

14.11.2023

Refractive surgery - Risks and benefits

Zittlau describes the challenges associated with visual aids such as glasses or contact lenses. Everyone who relies on visual aids is probably familiar with foggy glasses or itchy eyes. Laser eye surgery is therefore the long-awaited solution for many patients.

09.11.2023

Femto-LASIK Sets High Bar for Myopic Correction

That's the message from Miguel A. Teus, PhD, professor of ophthalmology in Madrid, at the ESCRS Winter Meeting in Vilamoura, Portugal, 2023. He addresses the comparison between femtosecond LASIK (FS-LASIK) and lens extrusion procedures, such as the SMILE procedure.

02.11.2023

Phakic intraocular lenses - what are they?

Phakic intraocular lenses are artificial lenses that are implanted in the eye to correct various types of visual defects such as myopia. In contrast to so-called multifocal lenses, no lens replacement takes place here. The phakic intraocular lens is implanted in front of the eye's natural lens.

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