Recent Advances in Cataract Treatment: A Review for Optometrists
Highlights
- Cataract Awareness Month is the ideal time to learn about recent advances in cataract treatment.
- Machine learning algorithms, dropless cataract surgery, and endoillumination procedures can improve the accuracy, safety, and efficacy of cataract treatment.
- Cloud-based image management solutions integrated into a practice management system can help optometrists create more effective treatment plans for cataract patients.
- Optometrists can make a big difference in the lives of their patients by spreading awareness of cataract risk.
Cataracts are the leading cause of blindness worldwide, and current surgical interventions to remove a clouded lens are 90% effective but carry a risk of vision loss, infection, or retinal detachment.
Cataract Awareness Month is a time for optometrists to stay up to date on the recent advances in cataract treatment. These advances, such as dropless surgery and new intraocular lenses, can help improve the accuracy, safety, and speed of cataract surgery.
By being aware of these advances, optometrists ensure their patients receive the best possible surgical outcomes.
Machine Learning in Predicting Vision Outcomes
Machine learning could potentially be used to predict vision outcomes for cataract patients post surgery. This is because machine learning can analyze large amounts of data to identify patterns that would be difficult for humans to see. This data can include patient demographics, medical history, and surgical outcomes.
Machine learning can help optometrists select the right intraocular lenses (IOLs) for patients, leading to better vision outcomes. Additionally, machine learning can help optometrists identify patients who are at risk for complications so they can prescribe an alternative treatment.
A 2023 article in Ophthalmology Times discussed a machine learning platform developed by Oculotix, which has the potential to help surgeons select the right intraocular lenses (IOLs) for patients more quickly and confidently. The platform uses patient feedback, preoperative characteristics, and anatomic factors to match IOLs to patients.
A 2019 study evaluated the potential of two machine learning models, SVM-RM and MLNN-EM, to improve the accuracy of intraocular lens (IOL) power calculation. The models were trained on a dataset of 2,194 eyes and were found to perform significantly better than the current clinical method. The models were also slightly better than the Barrett Universal II formula, which is considered by many to be the most accurate IOL calculation formula.
Dropless Cataract Surgery: A Cost-Effective Approach
Following conventional cataract surgery, patients are required to administer antibiotic or analgesic eye drops to help them recover and prevent post-operative complications.
Dropless cataract surgery is a newer procedure that uses an intraoperative injection of medications to prevent infection and inflammation after surgery, eliminating the need for patients to take multiple eye drops several times a day, which can be inconvenient and costly.
A 2023 article outlining a presentation by Dr. Ravi Parikh and colleagues found that dropless cataract surgery could save the healthcare system over $450 million annually. This is because dropless surgery is less expensive than traditional surgery and reduces the need for patients to purchase and administer eye drops.
In addition to lower costs, dropless surgery can improve patient compliance and reduce the risk of complications. Non-adherence to post-surgical eye drop application is approximately 30%, increasing the risk of post-surgical complications.
As of this writing, however, intracameral injections have not been approved by the FDA, so its use is considered off-label.
Cataract Surgery in Opaque Cornea Cases
Cataract surgery is a safe and effective procedure that can restore vision in patients with cataracts. However, the surgery can be more challenging in patients with corneal opacity, and the outcomes may not be as good; the corneal opacity can make it difficult to visualize and implant the intraocular lens (IOL).
There are two main surgical options for patients with corneal opacity and cataracts. The first option is to perform cataract surgery alone. This can improve vision, but the results may not be as good as in patients without corneal opacity. The second option is to perform simultaneous penetrating keratoplasty (PKP) and cataract surgery. This surgery is more complex but can provide better long-term vision.
The decision on whether to perform cataract surgery alone or simultaneous PKP and cataract surgery is made on a case-by-case basis. The patient’s age and overall health and the severity of the corneal opacity are all considered.
It is important to evaluate patients with corneal opacity before cataract treatment carefully. This includes a thorough eye exam and a discussion of the risks and benefits of the different surgical options.
A 2023 article reported that cataract surgery can effectively improve vision in patients with corneal opacity. However, the decision of whether to perform corneal graft surgery at the same time depends on the patient’s status and the surgeon’s skills.
In cases where the corneal opacity is dense and central, penetrating keratoplasty or deep anterior lamellar keratoplasty may be considered at the time of cataract surgery. However, corneal grafting is unnecessary in many cases, saving time and inconvenience for the patient and surgeon.
The article also found that endoillumination procedures, capsular staining, and micro instruments can help surgeons to improve surgical visualization and perform these cases successfully.
Cataract Surgery Safety with Macular Degeneration
Cataract surgery can be challenging in people with age-related macular degeneration (AMD) due to the retinal damage that occurs as part of the disease. This makes it difficult for patients to sense light and may impede their ability to see after cataract surgery.
People with AMD are more likely to develop complications after cataract surgery, such as inflammation and bleeding, and many people mistakenly believe that cataract surgery can cause further deterioration in patients with AMD.
However, a recent National Eye Institute (NEI) study found that cataract surgery does not increase the risk of developing advanced AMD. The findings of this study suggest that people with AMD can safely undergo cataract surgery without fear of worsening their condition.
Additionally, the study’s findings indicate that using phacoemulsification, a minimally invasive cataract surgery technique, may be associated with a lower risk of advanced AMD than older cataract surgery techniques. This is because phacoemulsification causes less damage and inflammation to the eye than conventional techniques.
Imaging for Cataract Detection
RevolutionEHR can help optometrists track the progression of cataracts and assess the success of cataract removal surgery.
RevImaging, a cloud-based image management solution that seamlessly with RevolutionEHR, can help with cataract diagnosis and treatment by providing a more efficient way to store, view, and compare multiple images. This can help monitor cataract progression over time and compare images before and after surgery.
RevImaging’s SmartViews feature allows you to view up to eight images simultaneously so that you can compare different views of the same eye or images taken at different times. The filtering feature allows you to apply different filters to images to highlight specific details of the eye.
With SyncViews, RevImaging enables you to apply actions across multiple images, which can save time during image reviews. RevImaging is also DICOM compatible, ensuring you can access, store, and view images from various sources.
Support Your Patients’ Eye Health With RevolutionEHR
Schedule a demo with a RevolutionEHR Specialist today to find out how integrated cloud-based practice management software can help you detect and treat patients with cataracts and improve their health outcomes, giving you the freedom to focus on providing exceptional patient care.
