Current opinion in ophthalmology (Curr Opin Ophthalmol )

Publisher: Lippincott, Williams & Wilkins

Description

Topics Covered: Cataract Surgery and Lens Implantation; Glaucoma; Retina and Vitreous Disorders; Corneal and External Disorders and Refractive Surgery; Strabismus; Oculoplastic and Orbital Surgery; Neuro-ophthalmology; Ocular Manifestations of Systemic Disease.

  • Impact factor
    2.49
  • 5-year impact
    0.00
  • Cited half-life
    5.30
  • Immediacy index
    0.35
  • Eigenfactor
    0.01
  • Article influence
    0.00
  • Website
    Current Opinion in Ophthalmology website
  • Other titles
    Current opinion in ophthalmology (Online), Current opinion in ophthalmology
  • ISSN
    1531-7021
  • OCLC
    36903873
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Lippincott, Williams & Wilkins

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • Pre-print must be removed upon acceptance for publication
    • Post-print may be deposited in personal website, university's institutional repository or employers intranet
    • Publisher's version/PDF cannot be used
    • Must include statement that it is not the final published version
    • Published source must be acknowledged with full citation
    • Must link to publisher version
    • NIH, Wellcome Trust and HHMI authors will have their accepted manuscripts transmitted to PubMed Central on their behalf (see policy for details)
  • Classification
    ‚Äč yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Ophthalmologists are dependent on computed tomography (CT) and MRI to aid in the diagnosis and management of patients with orbital and visual conditions. Pitfalls in the imaging process can lead to inefficient care or patient harm. This review summarizes these problems and provides methods to reduce imaging errors.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: Asians make up the world's largest ethnic group, and the eyelid is one of the most prominent features of the face, regardless of race. Recent advances in Asian eyelid research have improved the understanding of its unique anatomy and, more importantly, highlighted differences surgeons should be aware of when performing Asian eyelid surgery.
    Current opinion in ophthalmology 05/2014;
  • Current opinion in ophthalmology 05/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: To review the various steps and methods in managing residual refractive error after laser in situ keratomileusis and photorefractive keratectomy (PRK).
    Current opinion in ophthalmology 05/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: This article reviews the current methods of improving outcomes when cataract surgery and endothelial keratoplasty are performed together.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: Laser refractive surgery (LRS) is one of the most common elective procedures performed in the USA today. Patients should be rigorously screened for certain ocular and systemic conditions, which may represent contraindications to LRS. Before treating, the refractive surgeon should be aware of the Food and Drug Administration (FDA) labeling for the procedure as well as what other evidence, such as clinical studies, case series, cases reports, and anecdotal evidence, exists. The purpose of this article is to review contraindications to having LRS.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: To update the knowledge on differences between mechanical microkeratome and femtosecond flaps for laser in-situ keratomileusis (LASIK) in terms of accuracy and complications.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: Eye-bank preparation of endothelial tissue for keratoplasty continues to evolve. Although eye-bank personnel have become comfortable and competent at Descemet's stripping automated endothelial keratoplasty (DSAEK), tissue preparation and tissue transport, optimization of preparation methods continues. Surgeons and eye-bank personnel should be up to date on the research in the field. As surgeons transit to Descemet's membrane endothelial keratoplasty (DMEK), eye banks have risen to the challenge of preparing tissue. Eye banks are refining their DMEK preparation and transport techniques.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: Astigmatism is a common refractive error that affects a significant portion of the population. This is a review of the most salient topics on assessing astigmatism as well as a discussion of the latest developments in surgical options and newest technologies to improve outcomes.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: Corneal transplantation remains the gold-standard treatment for bullous keratopathy patients as it provides symptomatic relief and visual rehabilitation. As corneas are not always available for transplant, alternative treatments have to be considered for alleviation of discomfort and pain. Various treatment options available in such cases include conjunctival flaps, anterior stromal puncture, amniotic membrane transplantation, phototherapeutic keratectomy, bandage contact lenses, and hypertonic saline eye drops. A combination of the above treatments can be employed depending upon the severity of bullous keratopathy and co-existing corneal edema. New potential treatments include collagen cross-linking (CXL), cultured endothelial cell injection, and topical treatment with Rho-associated kinase (ROCK) inhibitor. There is a lack of clinical trials comparing the safety and efficacy of the currently available treatment options for the management of bullous keratopathy. The effect of these treatments on subsequent corneal transplant has not been observed. CXL seems to offer short-term benefit for relief of pain. Newer potential treatment modalities such as ROCK inhibitors are claimed to be useful for the reversal of early edema associated with corneal endothelial dysfunction; however, long-term clinical trials are awaited.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: Descemet stripping endothelial keratoplasty has superseded penetrating keratoplasty (PKP) in adults as the procedure of choice for treating endothelial dysfunction, but endothelial keratoplasty despite the multitude of advantages has undergone a much slower adoption in pediatric patients. This review focuses on the recent advances made in the field of pediatric endothelial keratoplasty and the associated surgical challenges. Pediatric endothelial keratoplasty does not require as many sutures as PKP, and the wound size is smaller and more stable. Endothelial keratoplasty grafts clear faster, possibly allowing for a more effective management of amblyopia. Visual outcomes appear to be comparable with PKP but with a lower complication rate. As corneal surgeons grow more and more familiar with the nuances of pediatric endothelial keratoplasty, our understanding of this procedure will become more complete. The limited data available suggest that endothelial keratoplasty is a suitable surgical alternative to PKP in children.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: Due to alterations in corneal structure and biomechanics, intraocular pressure (IOP) measurement after refractive surgery has questionable accuracy. Numerous devices and techniques have been evaluated in the past decade. Whereas some methods clearly underestimate postoperative IOPs, other promising leads have emerged that are less affected by laser ablative procedures. It is well established that Goldmann applanation tonometry (GAT) underestimates IOP after refractive surgery. The discussion on the accuracy of different techniques of IOP measurement after refractive surgery remains ongoing. Evidence suggests that techniques that are less reliant on corneal structure and biomechanics may provide less altered IOPs postoperatively. Therefore, devices such as Dynamic Contour Tonometry and tonopen may have great utility after laser ablative surgery. GAT may not be the best method of measuring IOP after refractive surgery. Other devices may be superior to the GAT in providing more accurate IOP postoperatively. It is imperative that clinicians are aware of the possible inaccuracy of IOP acquisition after refractive surgery, in order to provide optimal monitoring for the development and progression of glaucoma.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: To elaborate on the recent concept of Descemet membrane endothelial transfer (DMET) and to explore the concepts that underpin its success through reviewing the key articles that have challenged our current understanding of corneal endothelial cell behavior. DMET challenges the paradigm that complete graft-host apposition is required for successful corneal clearance in endothelial keratoplasty. It offers the promise of a simpler procedure to restore corneal clarity. Its success may lie in the ability of endothelial cells to migrate and proliferate. Endothelial host cells have been found in isolation and at disparate locations among donor cells within the corneal buttons of patients who have had a penetrating keratoplasty. New evidence for the continued slow proliferation of endothelial cells from the corneal periphery throughout life comes from the microanatomy of the peripheral cornea, and the demonstration of stem cell markers and markers of DNA synthesis in this area. DMET offers us a tantalizing taste of a simpler way of treating corneal endothelial disease by harnessing the ability of corneal endothelial cells to migrate and proliferate. An understanding of these processes will be the key stepping stone to developing future treatments for corneal endothelial disease.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: Treatment of hyperopia presents greater challenges than treatment of myopia for multiple reasons, including the fact that hyperopia tends to progress with age and becomes more symptomatic with the loss of accommodation. Despite these issues, surgeons have multiple options to treat hyperopia successfully. Modern laser vision correction has high success rates for most patients and performs acceptably in the presence of high hyperopia or high cylinder. Early studies combining excimer laser treatment with collagen cross-linking (CXL) suggest that this may improve refractive stability. Recent studies have also described femtosecond lenticule extraction and use of a solid-state laser in place of the excimer. In addition to cornea-based treatment, long-term studies of a hyperopic phakic intraocular lens have shown excellent visual outcomes and good safety. Cross-linking is increasingly being applied to the hyperopia that follows radial keratotomy. The established treatments for hyperopia continue to accumulate evidence supporting their safety and efficacy. The next step forward in treatment may arise from combining these treatments with CXL to stabilize the cornea long-term.
    Current opinion in ophthalmology 05/2014;
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    ABSTRACT: To update on the recent developments and surgical applications of intraocular endoscopy, and highlight its role in the modern era of microincision vitreoretinal surgery. Recent progress in our understanding of the unique intraocular illumination properties of endoscopy, specifically the use of reflected (coaxial) versus conventional transmitted (dissociated) light, is redefining its role in vitreoretinal surgery. Indications for endoscope-enabled intraoperative viewing during pars plana vitrectomy include posterior segment disease with significant anterior segment opacity, difficult-to-access retroirideal diseases involving the sclerotomy, pars plana, pars plicata, ciliary sulcus, ciliary body, or peripheral lens, and complex anterior retinal detachments, particularly in diseases in children. The recent introduction of 23-gauge endoscope that works with standard microcannulas increases its utility. Endoscopic vitrectomy, particularly with the recent advent of 23-gauge technology, expands our surgical armamentarium, making it a useful complement to conventional viewing systems.
    Current opinion in ophthalmology 05/2014; 25(3):195-206.
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    ABSTRACT: To provide an update on the rapidly evolving methods for assessing prognosis and predicting response to targeted molecular therapy in uveal melanoma. The techniques for assessing prognosis in uveal melanoma have evolved from simple physical features, such as tumor size, location, and cell morphology, to the slightly more sophisticated counting of chromosomal gains and losses. More recently, gene expression profiling has provided a highly accurate and biologically informative gold standard for molecular prognostication. The latest step in the evolution of molecular testing has been the recent discovery of major driver mutations that allow predictive testing of response to targeted molecular therapies. Mutations in GNAQ and GNA11 are early events that promote cell proliferation, and these mutations are sensitive to MAPK kinase, PKC, and AKT inhibitors. Mutations in BAP1, SF3B1, and EIF1AX are later events that are largely mutually exclusive. Mutations in BAP1 are strongly associated with metastasis, whereas those in SF3B1 and EIF1AX are associated with good prognosis. Uveal melanomas with BAP1 mutations demonstrate sensitivity to epigenetic modulators, such as histone deacetylase inhibitors. Clinical trials are now available to evaluate the efficacy of these targeted molecular agents in patients with uveal melanoma. Molecular prognostic testing and enrollment of high-risk patients into clinical trials of targeted molecular therapy are rapidly becoming the standard of care in the management of uveal melanoma.
    Current opinion in ophthalmology 05/2014; 25(3):234-9.
  • Current opinion in ophthalmology 03/2014;
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    ABSTRACT: To review the current literature regarding long-term treatment beyond 2 years with anti-vascular endothelial growth factor (VEGF) inhibition for neovascular age-related macular degeneration (nv-AMD). Only few studies of anti-VEGF treatment for nv-AMD exist beyond 2 years, and the number of patients followed for 4 years or longer is small. The results of studies show that the majority of patients with nv-AMD can preserve visual acuity compared with baseline, subgroups reveal large variations in visual benefit. Approximately 20-30% of patients seem to respond poorly to the treatment, and 20% obtain a condition with inactivity and good results. The majority of patients will need continuous active treatment. Long-term decline of visual acuity reflects the natural progression of the disease, however, insufficient treatment cannot be excluded leaving a potential for further improvement. Close follow-up to detect recurrent activity of nv-AMD and activity in fellow eye is important. Definitive evidence of systemic side-effects is lacking, but long-term VEGF inhibition seems to be tolerated well with few ocular and systemic complications. The majority of patients with nv-AMD can preserve visual acuity and expect long-term treatment beyond 2 years. Ocular complications and systemic adverse events remain few.
    Current opinion in ophthalmology 03/2014;
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    ABSTRACT: The healthcare system creates a vast amount of data that are utilized by a wide variety of entities for a multitude of purposes. Physicians have traditionally been unable to control who has access to their data or how their data are used. The widespread adoption of the Electronic Health Record (EHR) by physicians will create a larger and more valuable healthcare data market with broad implications for the healthcare system. It is, therefore, important for physicians to understand the evolving healthcare data market and the importance of maintaining ownership of and control over their electronic health data. Several entities, including private health insurance companies, federal payers, medical societies, and pharmaceutical companies are increasingly utilizing healthcare data to drive reimbursement policies and commercial initiatives. Given the critical importance that EHR data will play in multiple aspects of the healthcare industry, it is in physicians' interest to maintain ownership and control of the healthcare data that they generate. It would be prudent for physicians to exercise caution before relinquishing data rights to entities that may sell the data to payers or other customers with whom physicians' interests may not be aligned.
    Current opinion in ophthalmology 03/2014;
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    ABSTRACT: Artificial corneas are being developed to meet a shortage of donor corneas and to address cases in which allografting is contraindicated. A range of artificial corneas has been developed. Here we review several newer designs and especially those inspired by naturally occurring biomaterials found with the human body and elsewhere. Recent trends in the development of artificial corneas indicate a move towards the use of materials derived from native sources including decellularized corneal tissue and tissue substitutes synthesized by corneal cells in vitro when grown either on their own or in conjunction with novel protein-based scaffolds. Biologically inspired materials are also being considered for implantation on their own with the view to promoting endogenous corneal tissue. More recent attempts at making artificial corneas have taken a more nature-based or nature-inspired approach. Several will in the near future be likely to be available clinically.
    Current opinion in ophthalmology 03/2014;