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John A. Hovanesian, MD, FACS, focuses his blog on new technologies and innovations and how ophthalmic practices can best incorporate them to benefit patients.
Tuesday, December 15, 2009
John A. Hovanesian, MD, FACS
By now, most of us have heard that femtosecond lasers are being developed to assist in cataract surgery. The U.S. Food and Drug Administration has already granted 510(k) clearance for creation of anterior capsulotomies. Currently three (maybe more) companies are pursuing this technology: OptiMedica, LenSx and LensAR.
Thursday, October 1, 2009
John A. Hovanesian, MD, FACS
When I first heard of the idea of disposable cataract instruments, my first reaction was, "WWAGD?" ("What Would Al Gore Do?") This thought passed fairly quickly, though, when I began to think about the advantages such tools had (and heard that the former veep has his own private jet and I don't).
Friday, September 25, 2009
John A. Hovanesian, MD, FACS
How often do we wish we had a photo of what a patient's fundus looked like 5 or more years ago? In my own practice, this question comes up quite frequently as I look at a little RPE irregularity in the macula or perhaps an optic disc whose neuroretinal rim looks a little thin. Is this the beginning of a progressive disease state or an old finding that just isn't part of the patient's known history?
Monday, September 21, 2009
John A. Hovanesian, MD, FACS
Since the widespread availability of Descemet's stripping endothelial keratoplasty, have you noticed how much simpler the discussion of cataract surgery has become for patients with Fuchs' dystrophy? Before DSEK, most of us cataract surgeons probably spent many hours explaining to Fuchs' patients how their upcoming cataract surgery might make their vision worse. To be sure, corneal decompensation still happens after cataract surgery, despite newer viscoelastics and phacoemulsification technology. But the significance of a decompensated cornea is now a much simpler matter to correct, thanks to DSEK.
Tuesday, June 16, 2009
John A. Hovanesian, MD, FACS
Sometimes the combination of two or more well-established technologies yields a new and better treatment for an old problem. So I've found with phototherapeutic keratectomy combined with a diamond burr for the treatment of anterior basement membrane dystrophy.
Tuesday, June 9, 2009
John A. Hovanesian, MD, FACS
How many of our patients who are prescribed eye drops for QID actually use them faithfully four times a day? According to studies of patient compliance, less than 50% of patients do. So how compliant are our postoperative cataract patients with a QID regimen of steroid, nonsteroidal and antibiotic?
Tuesday, June 2, 2009
John A. Hovanesian, MD, FACS
Note this post discusses an off-label use of azithromycin.
Monday, May 11, 2009
John A. Hovanesian, MD, FACS
Chemosis during surgery may stretch Tenon's fascia and predispose to postoperative development of conjunctival chalasis symptoms.
Chemosis during surgery may stretch Tenon's fascia and predispose to postoperative development of conjunctival chalasis symptoms.
Conjunctival chemosis sometimes occurs during cataract surgery when a clear corneal incision (whether primary incision or paracentesis) is placed posteriorly enough that leaking fluid exiting the eye can be partially diverted under the conjunctiva. When the conjunctiva balloons forward, balanced salt solution can pool on the corneal surface, altering the optics of the view of the anterior chamber and making the procedure difficult.
Tuesday, May 5, 2009
John A. Hovanesian, MD, FACS
Conjunctival chalasis is a common and frustrating ocular surface condition that causes discomfort and pain. It often follows cataract, blepharoplasty or other procedures that can affect the ocular surface. Chalasis refers to relaxation of tissue, and in this case, redundant conjunctiva becomes loose because of the absence of Tenon's fascia.
Thursday, April 23, 2009
John A. Hovanesian, MD, FACS
Here is a new technology I am particularly excited about.