Intraocular lenses in age-related macular degeneration.

PURPOSE: The aim of this work is to review the lenses, assessing their advantages and disadvantages. We describe a total of seven types of intraocular lenses (IOLs) recommended for age-related macular degeneration (AMD). METHODS: We used the PubMed web platform to search for implantable devices in various stages of AMD. We searched for both prospective and retrospective studies and also case reports. RESULTS: Clinical results in AMD patients have been described for a total of seven types of IOLs recommended for AMD: an implantable miniature telescope (IMT), IOL-VIP System, Lipshitz macular implant (LMI), sulcus-implanted Lipshitz macular implant, LMI-SI, Fresnel Prism Intraocular Lens, iolAMD and Scharioth Macula Lens. CONCLUSIONS: We conclude that to objectively ascertain the effectiveness and safety of these lenses, further independent clinical studies with longer follow-up data are necessary prior to the general use of these optical devices.

An Updated Review on the Most Common Agents Causing Toxic Optic Neuropathies.

BACKGROUND: Toxic optic neuropathies (TONs) often present with a gradual and bilateral decrease in visual acuity, scotomas and optic disc pallor. Obtaining an accurate history is the critical first step in determining the etiology of TONs. METHODS: This updated review contains a thorough analysis of the current PubMed-indexed literature on the most common agents responsible for TONs, including methanol, ethambutol, amiodarone, linezolid, tumor necrosis factor alpha inhibitors and phosphodiesterase 5 inhibitors. RESULTS: The reviewed articles are mainly case reports presenting new and controversial aspects of the above agents. New treatment strategies, such as erythropoietin for methanol optic neuropathy, are being proposed for TONs, a condition that was previously regarded as untreatable. CONCLUSION: TONs could cause significant disability due to visual impairment. In case of early diagnosis and drug withdrawal, most TONs are treatable. Patients need to be appropriately counseled, and prescribing physicians should be especially made aware of TON-inducing medications.

Pros and cons of immediately sequential bilateral cataract surgery (ISBCS).

Immediately sequential bilateral cataract surgery (ISBCS) is currently a "hot topic" in ophthalmology. There are well-documented advantages in terms of quicker visual rehabilitation and reduced costs. The risk of bilateral simultaneous endophthalmitis and bilateral blindness is now recognized to be minuscule with the advent of intracameral antibiotics and modern management of endophthalmitis. Refractive surprises are rare for normal eyes and with the use of optical biometry. Where a general anesthetic is indicated for cataract surgery, the risk of death from a second anesthetic is much higher than the risk of blindness. A widely recognized protocol from the International Society of Bilateral Cataract Surgeons needs to be adhered to if surgeons wish to start practicing ISBCS.

Update on Pharmacologic Retinal Vascular Toxicity.

Several medications are associated with retinal vascular toxicity. These include intraocular aminoglycosides, oral contraceptives, interferon alpha, several other agents, and talc, which occurs as a vehicle in some oral medications that may be abused intravenously. As a group, these entities represent a small but clinically relevant category of retinal toxicity from medications. Some of the manifestations (e.g., retinal vascular occlusion) are nonspecific, but others are more specific, including clinically visible talc emboli in retinal vessels. Toxicity may be asymptomatic or may cause irreversible visual loss. By maintaining a high index of suspicion, the correct diagnosis can usually be made.