Ophthalmology

One of the highlights of my week is spending time in the operating room with ophthalmology residents, because they are bright, hard-working and eager to learn as much as possible. This past week, they asked me about the use of femtosecond laser to assist with cataract surgery since I've slowly begun using it at our surgery center in Beverly Hills. While I think that the femtosecond laser can in certain ways improve my cataract surgical procedure, I think it can have a far greater benefit in helping more novice surgeons.

One of my favorite meetings of the year is the Hawaiian Eye meeting, and not just because of the opportunity to enjoy the beautiful islands. With the format of the meeting, it is easy to understand key take-home points and immediately incorporate them into my own practice. Here are some of my highlights: The cataract session led by David Chang and Roger Steinert was excellent as usual, and many speakers presented about toric IOLs. For preoperative evaluation, make sure that the patient has ...

I had the pleasure of attending a superb conference at USC's Doheny Eye Institute recently that focused on how to take an idea, patent it, get funding and move towards making it a reality. A notable example of this is the retinal chip implant that Mark Humayun, MD, PhD, took from an idea to a product that has received the European CE mark.

Fundus photos from phone. Photos of patient's fundus via phone. When I was a resident, anterior segment photos were taken with a large (and expensive) camera with a high-power macro lens. These days, I use a handheld digital camera to take most anterior segment photos, and now there's even a way to take good fundus photos with your cellular phone. You can take a photo of a patient's fundus and then email or text it to colleagues.

Area of zonular absence seen between cataract and iris.

Careful examination shows that this mature white cataract has formed over the course of many years. There is fibrosis and wrinkling of the anterior lens capsule. When instilling trypan blue dye in the eye, the visualization may improve, but it may still be difficult to perform a capsulorrhexis. This fibrotic capsule will not tear the same way as a smooth capsule, and there’s a high probability that micro-scissors, a vitrector or a cystotome will be needed to complete the anterior capsulotomy.

White cataract with a wrinkled anterior capsule White cataract with a wrinkled anterior capsule A patient presents to you with a unilateral mature white cataract, and before booking her surgery, you have a hunch that something isn't quite right ...

Hyperopic cataract patient Hyperopic cataract patient Cataract surgery is a pleasure because it restores vision to our patients and is technically an enjoyable procedure for the surgeon. When high degrees of hyperopia are corrected at the same time, it becomes almost magical.

The operating room is cluttered with cameras and cables in preparation for a live surgery event The operating room is cluttered with cameras and cables in prepar- ation for a live surgery event . At the large ophthalmology meetings, the live surgery events are always popular and attract a lot of attention. And for good reason — I think that live surgery is one of the best ways to learn about new techniques and technologies.

Corneal melt from generic ketorolac use. Corneal melt from generic ketorolac use. In 1999, corneal melts were reported by ASCRS members in a survey, and a connection to NSAIDs, particularly generic NSAIDs, was discovered. Although rare, this problem still exists today.

Vitreous in the anterior chamber of an aphakic eye Vitreous in the anterior chamber of an aphakic eye. A resident asked me if an IOL was required for a highly myopic eye in which the IOL calculations resulted in a power of 0 D. This case is a great example of why an IOL is still recommended even if its power is 0, because it can act as a barrier.