Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.1.30
A. Arrigo, F. Bandello
Age-related macular degeneration (AMD) is a leading cause of vision loss in developed countries. The advanced stages of AMD are characterized by the onset and progression of macular neovascularization or geographic atrophy. Several treatments are currently available for managing the neovascular form of AMD, based on intravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs. Although these agents are efficient in inducing fluid regression and preserving visual function, their limited duration of action and treatment burden are stimulating the development of new molecules with more prolonged pharmacological activity. The future of exudative AMD therapies will include new generations of anti-VEGF drugs, surgical anti-VEGF port delivery systems and novel molecules acting on other AMD pathogenic pathways. In contrast, dry AMD and geographic atrophy have no approved treatments; nutraceutical approaches still represent the only way to reduce the probability of AMD progression and the onset of complications. Several ongoing clinical trials are testing different molecules that have been developed to slow the progression of geographic atrophy, including complement system inhibitors, integrin inhibitors, gene therapies and cell-based therapies. In this review, we provide an overview of the current state of the art and future perspectives for the management of dry and wet AMD.
{"title":"Towards the Development of Longer and More Efficacious Therapies for Wet and Dry Age-related Macular Degeneration","authors":"A. Arrigo, F. Bandello","doi":"10.17925/usor.2022.16.1.30","DOIUrl":"https://doi.org/10.17925/usor.2022.16.1.30","url":null,"abstract":"Age-related macular degeneration (AMD) is a leading cause of vision loss in developed countries. The advanced stages of AMD are characterized by the onset and progression of macular neovascularization or geographic atrophy. Several treatments are currently available for managing the neovascular form of AMD, based on intravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs. Although these agents are efficient in inducing fluid regression and preserving visual function, their limited duration of action and treatment burden are stimulating the development of new molecules with more prolonged pharmacological activity. The future of exudative AMD therapies will include new generations of anti-VEGF drugs, surgical anti-VEGF port delivery systems and novel molecules acting on other AMD pathogenic pathways. In contrast, dry AMD and geographic atrophy have no approved treatments; nutraceutical approaches still represent the only way to reduce the probability of AMD progression and the onset of complications. Several ongoing clinical trials are testing different molecules that have been developed to slow the progression of geographic atrophy, including complement system inhibitors, integrin inhibitors, gene therapies and cell-based therapies. In this review, we provide an overview of the current state of the art and future perspectives for the management of dry and wet AMD.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.1.40
C. Matossian
Continuous positive airway pressure (CPAP) use is highly beneficial. However, many patients using CPAP or nasal mask therapy (NMT) develop secondary ocular disorders. Adding to earlier research, a recent retrospective descriptive analysis of 330,926 patients with no diagnosis of dry eye disease prior to their first CPAP or NMT device claim provides further information on the prevalence and incidence of dry eye disease among patients using CPAP or other NMT devices to treat sleep apnoea. Researchers found clear evidence that, compared with the incidence of dry eye disease in the general adult population in the USA, the incidence of dry eye disease was higher in patients who used CPAP or a NMT device, particularly in the second year of use. Furthermore, the incidence of dry eye disease increased based on the length of time the CPAP device was used. This research reveals the need for multispecialty collaboration based on evidence that patients may be at risk for eye irritation secondary to airflow from mask leakage or retrograde nasolacrimal air escape.
{"title":"The Impact of Continuous Positive Airway Pressure Use on Dry Eye Disease","authors":"C. Matossian","doi":"10.17925/usor.2022.16.1.40","DOIUrl":"https://doi.org/10.17925/usor.2022.16.1.40","url":null,"abstract":"Continuous positive airway pressure (CPAP) use is highly beneficial. However, many patients using CPAP or nasal mask therapy (NMT) develop secondary ocular disorders. Adding to earlier research, a recent retrospective descriptive analysis of 330,926 patients with no diagnosis of dry eye disease prior to their first CPAP or NMT device claim provides further information on the prevalence and incidence of dry eye disease among patients using CPAP or other NMT devices to treat sleep apnoea. Researchers found clear evidence that, compared with the incidence of dry eye disease in the general adult population in the USA, the incidence of dry eye disease was higher in patients who used CPAP or a NMT device, particularly in the second year of use. Furthermore, the incidence of dry eye disease increased based on the length of time the CPAP device was used. This research reveals the need for multispecialty collaboration based on evidence that patients may be at risk for eye irritation secondary to airflow from mask leakage or retrograde nasolacrimal air escape.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.2.72
James Tian, Esteban A Peralta, Kourtney H. Houser
Acanthamoeba keratitis (AK) is a potentially devastating infection of the ocular surface caused by amoebas of the genus Acanthamoeba. Although the organism is classically known for being difficult to detect and treat, recent advances in the field have greatly improved diagnostic accuracy and treatment efficacy. In this update, we review the current body of knowledge about AK epidemiology and pathogenesis, discuss the advances in diagnosis with confocal microscopy and polymerase chain reaction, and explore potential novel treatments such as voriconazole, miltefosine, topical steroids, phototherapeutic keratectomy, cross-linking and photodynamic therapy.
{"title":"An Update on Advances in Diagnosis and Treatment of Acanthamoeba Keratitis","authors":"James Tian, Esteban A Peralta, Kourtney H. Houser","doi":"10.17925/usor.2022.16.2.72","DOIUrl":"https://doi.org/10.17925/usor.2022.16.2.72","url":null,"abstract":"Acanthamoeba keratitis (AK) is a potentially devastating infection of the ocular surface caused by amoebas of the genus Acanthamoeba. Although the organism is classically known for being difficult to detect and treat, recent advances in the field have greatly improved diagnostic accuracy and treatment efficacy. In this update, we review the current body of knowledge about AK epidemiology and pathogenesis, discuss the advances in diagnosis with confocal microscopy and polymerase chain reaction, and explore potential novel treatments such as voriconazole, miltefosine, topical steroids, phototherapeutic keratectomy, cross-linking and photodynamic therapy.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.1.6
Ashish Sharma, B. Kuppermann, A. Loewenstein
Biosimilars have been spreading widely in the field of ophthalmology since the patent expiry of innovator molecules. The patent of the ranibizumab innovator has already expired, and the aflibercept patent will expire in the next few years. India was the first country to launch the biosimilar of ranibizumab (Razumab, Intas Pharmaceuticals Ltd, Ahmedabad, Gujarat, India) in 2015, whose usage has increased over time. After the US Food and Drug Administration approval of ranibizumab's biosimilar, ranibizumab-nuna (Byooviz™, Biogen, Cambridge, MA, USA), it will be interesting to witness the future of these molecules along with that of biobetters, which are yet to be well defined.
{"title":"The Future of Biosimilars and Biobetters in Ophthalmology","authors":"Ashish Sharma, B. Kuppermann, A. Loewenstein","doi":"10.17925/usor.2022.16.1.6","DOIUrl":"https://doi.org/10.17925/usor.2022.16.1.6","url":null,"abstract":"Biosimilars have been spreading widely in the field of ophthalmology since the patent expiry of innovator molecules. The patent of the ranibizumab innovator has already expired, and the aflibercept patent will expire in the next few years. India was the first country to launch the biosimilar of ranibizumab (Razumab, Intas Pharmaceuticals Ltd, Ahmedabad, Gujarat, India) in 2015, whose usage has increased over time. After the US Food and Drug Administration approval of ranibizumab's biosimilar, ranibizumab-nuna (Byooviz™, Biogen, Cambridge, MA, USA), it will be interesting to witness the future of these molecules along with that of biobetters, which are yet to be well defined.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.2.85
Michael Y. Zhao, Ujalashah Dhanani, Chao Charoenkijkajorn, M. Pakravan, P. Mortensen, Andrew G. Lee
Giant cell arteritis (GCA) is the most common vasculitis in adults, and patients with GCA often present with vision loss that may progress to permanent blindness. For this reason, empirical treatment with corticosteroids is initiated when there is reasonable suspicion of GCA. Corticosteroids have remained the mainstay of treatment for GCA for the past 70 years due to their profound immunosuppressive effects. However, not all patients tolerate or respond adequately to corticosteroids, and prolonged dosages increase the risk for adverse side effects. There have also been recent advances and investigations into alternative immunosuppressive therapies for GCA; specifically, interleukin 6 inhibitors and other alternatives have been approved by the American College of Rheumatology and European League Against Rheumatism for adjunctive use with corticosteroids or for refractory GCA. However, it is unclear whether current immunosuppressive alternatives can conclusively replace corticosteroids in the treatment of GCA and prevention of vision loss. This article reviews the robust immunosuppressive mechanisms of corticosteroids and summarizes clinical investigations of alternative therapies for GCA.
{"title":"Immunosuppressive Therapy in Giant Cell Arteritis: Do Steroids Still Reign Supreme?","authors":"Michael Y. Zhao, Ujalashah Dhanani, Chao Charoenkijkajorn, M. Pakravan, P. Mortensen, Andrew G. Lee","doi":"10.17925/usor.2022.16.2.85","DOIUrl":"https://doi.org/10.17925/usor.2022.16.2.85","url":null,"abstract":"Giant cell arteritis (GCA) is the most common vasculitis in adults, and patients with GCA often present with vision loss that may progress to permanent blindness. For this reason, empirical treatment with corticosteroids is initiated when there is reasonable suspicion of GCA. Corticosteroids have remained the mainstay of treatment for GCA for the past 70 years due to their profound immunosuppressive effects. However, not all patients tolerate or respond adequately to corticosteroids, and prolonged dosages increase the risk for adverse side effects. There have also been recent advances and investigations into alternative immunosuppressive therapies for GCA; specifically, interleukin 6 inhibitors and other alternatives have been approved by the American College of Rheumatology and European League Against Rheumatism for adjunctive use with corticosteroids or for refractory GCA. However, it is unclear whether current immunosuppressive alternatives can conclusively replace corticosteroids in the treatment of GCA and prevention of vision loss. This article reviews the robust immunosuppressive mechanisms of corticosteroids and summarizes clinical investigations of alternative therapies for GCA.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.2.54
S. McGee, George O Waring Iv
Presbyopia is a progressive, age-related condition that reduces the eye’s ability to focus on near objects. If uncorrected or undercorrected, presbyopia can negatively impact people’s daily activities and quality of life. Until recently, standard treatments comprised corrective glasses or contact lenses and surgical procedures, all of which fail to restore natural accommodation of the lens and are associated with inconvenience and/or potential ocular complications. Pilocarpine hydrochloride (HCl) ophthalmic solution 1.25% (Vuity™; Allergan, an AbbVie Company, North Chicago, IL, USA) is the first and, at the time of writing, only topical agent approved by the United States Food and Drug Administration to treat presbyopia. Pilocarpine HCl ophthalmic solution 1.25% is formulated in a proprietary vehicle using pHast™ technology, which allows rapid equilibration to the physiological pH of the tear film to enhance bioavailability and reduce side effects such as ocular discomfort and vision blur. Clinical trials in individuals with presbyopia have demonstrated that pilocarpine HCl 1.25% is well tolerated and leads to rapid improvements in near and intermediate vision, without impacting distance vision. In this article, we discuss the mechanism of action of pilocarpine HCl 1.25%, preclinical and clinical evidence supporting its use in presbyopia, and its value in providing a non-invasive, reversible, glasses-free alternative for managing presbyopia.
{"title":"Pilocarpine Hydrochloride Ophthalmic Solution 1.25%: An Innovative Prescription Eye Drop for the Treatment of Presbyopia","authors":"S. McGee, George O Waring Iv","doi":"10.17925/usor.2022.16.2.54","DOIUrl":"https://doi.org/10.17925/usor.2022.16.2.54","url":null,"abstract":"Presbyopia is a progressive, age-related condition that reduces the eye’s ability to focus on near objects. If uncorrected or undercorrected, presbyopia can negatively impact people’s daily activities and quality of life. Until recently, standard treatments comprised corrective glasses or contact lenses and surgical procedures, all of which fail to restore natural accommodation of the lens and are associated with inconvenience and/or potential ocular complications. Pilocarpine hydrochloride (HCl) ophthalmic solution 1.25% (Vuity™; Allergan, an AbbVie Company, North Chicago, IL, USA) is the first and, at the time of writing, only topical agent approved by the United States Food and Drug Administration to treat presbyopia. Pilocarpine HCl ophthalmic solution 1.25% is formulated in a proprietary vehicle using pHast™ technology, which allows rapid equilibration to the physiological pH of the tear film to enhance bioavailability and reduce side effects such as ocular discomfort and vision blur. Clinical trials in individuals with presbyopia have demonstrated that pilocarpine HCl 1.25% is well tolerated and leads to rapid improvements in near and intermediate vision, without impacting distance vision. In this article, we discuss the mechanism of action of pilocarpine HCl 1.25%, preclinical and clinical evidence supporting its use in presbyopia, and its value in providing a non-invasive, reversible, glasses-free alternative for managing presbyopia.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.2.76
Joseph F. Panarelli, Anna Do
While treatment options available to patients with glaucoma are expanding, trabeculectomy and glaucoma drainage device implantation (GDI) remain a mainstay in glaucoma surgical care. This article reviews key aspects of bleb management following trabeculectomy and GDI surgery. Basics of postoperative management of trabeculectomy and GDIs are reviewed, as well as how to manage complications such as early and late bleb leaks, fibrosis, bleb dysesthesia and the hypertensive phase. In general, careful surgical technique, close postoperative monitoring and appropriate intervention can help patients achieve safe outcomes and long-term control of intraocular pressure.
{"title":"Bleb Management Following Trabeculectomy and Glaucoma Drainage Device Implantation","authors":"Joseph F. Panarelli, Anna Do","doi":"10.17925/usor.2022.16.2.76","DOIUrl":"https://doi.org/10.17925/usor.2022.16.2.76","url":null,"abstract":"While treatment options available to patients with glaucoma are expanding, trabeculectomy and glaucoma drainage device implantation (GDI) remain a mainstay in glaucoma surgical care. This article reviews key aspects of bleb management following trabeculectomy and GDI surgery. Basics of postoperative management of trabeculectomy and GDIs are reviewed, as well as how to manage complications such as early and late bleb leaks, fibrosis, bleb dysesthesia and the hypertensive phase. In general, careful surgical technique, close postoperative monitoring and appropriate intervention can help patients achieve safe outcomes and long-term control of intraocular pressure.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.2.98
Ashish Sharma, Nilesh Kumar, N. Parachuri, A. Loewenstein, F. Bandello, B. Kuppermann
Anti-vascular endothelial growth factors (anti-VEGF) have transformed retinal disease management. However, the benefit of anti-VEGF therapy is still limited by the high cost of treatment, specifically in areas where patients are not well covered with insurance and need to pay out of their pocket. Off-label bevacizumab usage has been associated with the risk of infection due to a lack of compounding pharmacies in such areas. In India, the entry of ranibizumab biosimilars has made a significant change and improved access to anti-VEGF therapy for many patients. Recent ranibizumab biosimilar approvals by the European Medicines Agency and the US Food and Drug Administration have brought this therapy to the forefront and have the potential to save the nation’s healthcare spending on these drugs. However, it is yet to be seen how biosimilar anti-VEGF therapy will fit into the crowded space of anti-VEGF therapy globally.
{"title":"Biosimilars in Ophthalmology: Financial Implications and Beyond","authors":"Ashish Sharma, Nilesh Kumar, N. Parachuri, A. Loewenstein, F. Bandello, B. Kuppermann","doi":"10.17925/usor.2022.16.2.98","DOIUrl":"https://doi.org/10.17925/usor.2022.16.2.98","url":null,"abstract":"Anti-vascular endothelial growth factors (anti-VEGF) have transformed retinal disease management. However, the benefit of anti-VEGF therapy is still limited by the high cost of treatment, specifically in areas where patients are not well covered with insurance and need to pay out of their pocket. Off-label bevacizumab usage has been associated with the risk of infection due to a lack of compounding pharmacies in such areas. In India, the entry of ranibizumab biosimilars has made a significant change and improved access to anti-VEGF therapy for many patients. Recent ranibizumab biosimilar approvals by the European Medicines Agency and the US Food and Drug Administration have brought this therapy to the forefront and have the potential to save the nation’s healthcare spending on these drugs. However, it is yet to be seen how biosimilar anti-VEGF therapy will fit into the crowded space of anti-VEGF therapy globally.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.2.92
Anna K. Wu, David D Chong, Rishi P. Singh
Anti-vascular endothelial growth factor (anti-VEGF) injections are a mainstay of treatment for retinal vascular diseases such as neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DMO) and retinal vein occlusion. While anti-VEGF monotherapy has helped improve visual outcomes in patients with these conditions, the need for frequent injections and follow-up visits, as well as the varying response to therapy are notable shortcomings. To address this, novel therapies have been investigated as adjuncts or alternatives to anti-VEGF monotherapy. One such therapy is faricimab, the first US Food and Drug Administration-approved intravitreal injection designed to target both VEGF-A and angiopoietin-Tie-2 for the treatment of nAMD and DMO. Clinical trial data thus far support that faricimab produces non-inferior visual and anatomical outcomes to standard anti-VEGF therapy, with longer durability, in these diseases. In this review, details regarding faricimab’s molecular development, clinical trial outcomes, and its prospect as the newest drug in the treatment landscape for retinal diseases will be discussed.
{"title":"Faricimab in the Treatment Landscape for Retinal Diseases: A Review","authors":"Anna K. Wu, David D Chong, Rishi P. Singh","doi":"10.17925/usor.2022.16.2.92","DOIUrl":"https://doi.org/10.17925/usor.2022.16.2.92","url":null,"abstract":"Anti-vascular endothelial growth factor (anti-VEGF) injections are a mainstay of treatment for retinal vascular diseases such as neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DMO) and retinal vein occlusion. While anti-VEGF monotherapy has helped improve visual outcomes in patients with these conditions, the need for frequent injections and follow-up visits, as well as the varying response to therapy are notable shortcomings. To address this, novel therapies have been investigated as adjuncts or alternatives to anti-VEGF monotherapy. One such therapy is faricimab, the first US Food and Drug Administration-approved intravitreal injection designed to target both VEGF-A and angiopoietin-Tie-2 for the treatment of nAMD and DMO. Clinical trial data thus far support that faricimab produces non-inferior visual and anatomical outcomes to standard anti-VEGF therapy, with longer durability, in these diseases. In this review, details regarding faricimab’s molecular development, clinical trial outcomes, and its prospect as the newest drug in the treatment landscape for retinal diseases will be discussed.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.17925/usor.2022.16.1.8
N. Le, B. Marshall, Kourtney H. Houser, Sumitra S. Khandelwal
When vitreoretinal and anterior segment surgeons collaborate to perform concomitant cataract-vitreoretinal surgery (also known as phacovitrectomy) in the appropriate clinical setting, combined surgery can expedite visual recovery, improve the view and surgical access to the retina in cases with significant cataract, avoid multiple rounds of anaesthesia and reduce the financial burden on the patient. While combined surgery overcomes several limitations of sequential surgery, it is important to understand that phacovitrectomy may be associated with increased postoperative inflammation and less predictable refractive outcomes. We typically recommend combined phacovitrectomy in patients with significant cataract and vitreoretinal pathology, especially if the cataract impairs the view to the retina or if the patient is too ill to undergo several rounds of anaesthesia. In patients with high refractive expectations who have an early cataract or mild retinal pathology, combined surgery is not likely to be a viable or reasonable management option.
{"title":"Combined Pars Plana Vitrectomy, Phacoemulsification and Intraocular Lens Implantation: A review on the Advantages and Limitations of Phacovitrectomy","authors":"N. Le, B. Marshall, Kourtney H. Houser, Sumitra S. Khandelwal","doi":"10.17925/usor.2022.16.1.8","DOIUrl":"https://doi.org/10.17925/usor.2022.16.1.8","url":null,"abstract":"When vitreoretinal and anterior segment surgeons collaborate to perform concomitant cataract-vitreoretinal surgery (also known as phacovitrectomy) in the appropriate clinical setting, combined surgery can expedite visual recovery, improve the view and surgical access to the retina in cases with significant cataract, avoid multiple rounds of anaesthesia and reduce the financial burden on the patient. While combined surgery overcomes several limitations of sequential surgery, it is important to understand that phacovitrectomy may be associated with increased postoperative inflammation and less predictable refractive outcomes. We typically recommend combined phacovitrectomy in patients with significant cataract and vitreoretinal pathology, especially if the cataract impairs the view to the retina or if the patient is too ill to undergo several rounds of anaesthesia. In patients with high refractive expectations who have an early cataract or mild retinal pathology, combined surgery is not likely to be a viable or reasonable management option.","PeriodicalId":90077,"journal":{"name":"US ophthalmic review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67622160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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