A Model for Green Cataract Surgery

Kannusamy Veena, MD; Snigdha Mishra, MD; Rengaraj Venkatesh, MD

Eyetube

High Astigmatism With Underlying Ectasia

What are the options for reducing the patient’s spectacle dependence?

Priya M. Mathews, MD, MPH; Kanika Agarwal, MD; and Francis W. Price Jr, MD

Cataract and Refractive Surgery Today

CASE PRESENTATION A 58-year-old man is referred for a refractive surgery evaluation. The patient has no significant ocular history and has never undergone eye surgery. He began wearing glasses at a young age and desires spectacle independence. On examination, the patient’s uncorrected distance visual acuity is 20/100 OD and 20/80-1 OS. His BCVA is 20/20 OU with a manifest refraction of -3.00 +4.00 x 010º OD and -2.00 +3.50 x 010º OS. His current spectacle prescription is -2.50 +4.00 x 010º OD and -1.75 +3.50 x 010º OS. His Brightness Acuity Test is 20/30 OU. The patient is happy with the quality of his BSCVA. He has never worn contact lenses. He reports no problems with driving at night or recent changes in his manifest refraction.

Practice Makes Progress

Marion Munk, MD, and Justis P. Ehlers, MD

Retina Today

It’s always fascinating when trendy technology seeps into health care. While working on this issue, our news feeds were overrun with stories of surgeons using Apple’s new Vision Pro in the OR.1 According to the press release, a nurse used the device to help with instrument selection, data visualization, and procedure monitoring.1 Cool stuff, and even if you aren’t an Apple aficionado, you have to admit this “spatial computer” is impressive.2 The news caught our eyes, but it didn’t surprise us because the field of retina was way ahead of the curve with this technology. The first ophthalmic exoscope—the Beyeonics One visualization system—that integrates augmented reality into a surgical headset was installed into an ophthalmic surgical suite years ago.3 Not only that, but the company recently announced the integration of intraoperative OCT into the headset, making it something of a spatial computer itself—for the surgeon.4 Retina has always been a field defined by technologic advancement, and our imaging tools are a great example. In an explosion of innovation in the early 2000s, we saw the advent of 3D visualization in the OR, intraoperative OCT, and OCT angiography (OCTA). Since then, it has been a slow march of improvement. For example, the January/February issue highlighted the addition of fluorescein angiography to surgical 3D heads-up displays. Other issues have touched on scanning laser ophthalmoscope-based multimodal fundus imaging and ultra-widefield technologies for the detection of diabetic eye disease. To catch up on these articles, see Further Reading. Some technology still in the pipeline may be poised to hit the clinic in the next few years; K. Bailey Freund, MD, and others have been lecturing on high-resolution OCT for a while now, with Retina Today following closely since its inaugural issue in 2006.5 While researchers work on fine-tuning the next generation, we asked experts to share their insights to help you perfect your skills with the imaging tools at your disposal.