Future Intraocular Lens Technologies.

The future of intraocular lens (IOL) technology has already begun with a number of recent innovations. The postoperative change of refractive power will lead to a customized fine-tuning that provides patients with the individual vision they expect and with as much spectacle independence as possible. The latest-generation (2.0) Light-Adjustable Lens (RxSight) was recently introduced into clinical practice, with the first results being very encouraging. Other methods of altering the power of an already implanted IOL are under development. The same can be said about the correction of presbyopia, the so-called last frontier in refractive surgery. Extended depth-of-focus IOLs have been introduced, as has the technology of the pinhole IOL. The latter has therapeutic potential beyond the refractive aspect and has already proven helpful in cases of iris defects and irregular corneas. Several technologies are currently being tested to achieve-finally-an accommodative IOL. One such concept uses the (remaining) strength of the ciliary muscle, whereas another is triggered by the pupil reaction when shifting focus from far to near. Not an IOL itself, but rather a high-tech innovation that so far has mostly been implanted during cataract surgery, is a microelectronic sensor that measures habitual intraocular pressure (IOP) at any given time and promises to revolutionize the management of glaucoma patients. The last generation of this device (Eyemate; Implandata Opthalmics Products GmbH) is implanted during small-incision cataract surgery; the latest development is an even smaller sensor that will be inserted suprachoroidally before, in the near future, such a device will be part of a capsular ring. These IOP sensors are a prime example that IOL technology will continue to be a driving force in ophthalmology, with a positive impact far beyond cataract surgery.

Contributions to Progress in Ophthalmology from Switzerland: From the 16th to the 21st Century.

There are numerous contributions to the development of ophthalmology from Switzerland, a country that holds a very special place in the history of medicine from the age of Paracelsus and Vesal to the current time. This review gives an overview over these contributions and the pioneers, among them Johann Friedrich Horner, Hans Goldmann, Jules Gonin, and Walter Rudolf Hess, one of only two ophthalmologists ever awarded the Nobel Prize for Medicine. A leading role in this evolution of modern ophthalmology has been played by physicians from Basel, home of Switzerland's oldest university.

Miniaturization in Glaucoma Monitoring and Treatment: A Review of New Technologies That Require a Minimal Surgical Approach.

In the management of glaucoma, recent and upcoming innovations have the potential to contribute to both the efficacy of intraocular pressure (IOP) monitoring and the number of available treatment options. These new devices and procedures have two things in common: they are part of the trend in medicine towards miniaturization, and they require a limited surgical procedure to become effective. This review focuses on the Eyemate (Argos) intraocular sensor, which offers a new way to reliably measure 24 h IOP, and on intraocular sustained release systems for pharmacological glaucoma therapy. It also briefly reflects on the miniature implants currently used in minimally invasive glaucoma surgery (MIGS).

Femtosecond laser-assisted cataract surgery without ophthalmic viscosurgical devices.

PURPOSE: To describe a technique for performing femtosecond laser-assisted cataract surgery without the use of ophthalmic viscosurgical devices (OVDs). METHODS: After laser pretreatment, the anterior chamber is stabilized with balanced salt solution during lens and cortex aspiration. A preloaded intraocular lens is implanted under irrigation. RESULTS: In 23 eyes undergoing surgery without the use of OVDs, no complications were observed within a 1-month follow-up period. The time for surgery and the amount of fluid that went into the eye were similar to those of a standard procedure. There was no remarkable increase in intraocular pressure or corneal thickness. All patients achieved a significant increase in corrected distance visual acuity after surgery. CONCLUSIONS: The significant reduction of phacoemulsification use after femtosecond laser application might render the use of OVDs obsolete in many cases.