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The Literature | Oct 2015

Across the Pond


Unexpected Corneal Responses to CXL

By Farhad Hafezi, MD, PhD

Even in the hands of the most experienced surgeons, unexpected corneal responses to corneal collagen cross-linking (CXL) may occur, because the intricacies of the procedure are not yet fully understood. Unexpected corneal responses include corneal haze and remodeling, endothelial and stem cell damage, and infectious keratitis and corneal melt. Increased experience and published data will elucidate many of the unanswered questions associated with CXL and help surgeons to determine which protocol is best for their patients.


Treating Ectasia: the Changing Philosophy of Cornea Specialists

By Damian B. Lake, MB ChB, FRCOphth

CXL represents a shift in the philosophy from corneal transplantation to strengthening and resculpting ectatic corneal tissue to achieve better visual outcomes. With an epithelial disruption technique, perfusion of the stroma is achieved with isotonic riboflavin. Although this approach takes longer than conventional CXL, patients experience less pain. The next step of the procedure is refractive surgery in the form of cataract surgery or clear lens extraction.



Anterior Staining Solutions

By Elena Barraquer, MD; Thamotharan Naidu, MD; and Francis W. Price Jr, MD

Three surgeons discuss their preferences and approaches to the use of trypan blue dye for staining during anterior segment surgery. Quality and safety are the principal issues in selecting an appropriate dye to stain the capsule during anterior segment surgery.


Evolution of Preloaded IOL Insertion Systems

By Zia ul Mazhry, FRCS(Ed), FRCS (Glas), FCPS (Pakistan), CIC Ophth (Lond)

IOL manufacturers are working on the development of better preloaded IOL delivery systems to make the IOL’s size, design, and thickness more compatible with the disposable plunger and cartridge assembly. Not only will the healthy competition among manufacturers to achieve the best system provide surgeons with flawless IOL delivery, but it will also make these products more cost-effective.


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