Presently, there is no efficacious treatment for glaucomatous optic neuropathy; the current treatment is focused on lowering intraocular pressure (IOP). Studies have demonstrated the safety and efficacy of selective laser trabeculoplasty (SLT) in reducing the IOP in eyes with open-angle (OAG) glaucoma or ocular hypertension (OH). Moreover, the European Glaucoma Society has instated SLT as the first-line or adjunctive treatment in OAG or OH, reiterating its clinical significance. In this review, we outline the old and the new roles of SLT, with an emphasis on clinical practice, and look further into its renewed appeal and future developments.

The field of ophthalmology is expanding exponentially, both in terms of diagnostic and therapeutic capabilities, as well as the worldwide increasing incidence of eye-related diseases. Due to an ageing population and climate change, the number of ophthalmic patients will continue to increase, overwhelming healthcare systems and likely leading to under-treatment of chronic eye diseases. Since drops are the mainstay of therapy, clinicians have long emphasised the unmet need for ocular drug delivery. Alternative methods, i.e., with better compliance, stability and longevity of drug delivery, would be preferred. Several approaches and materials are being studied and used to overcome these drawbacks. We believe that drug-loaded contact lenses are among the most promising and are a real step toward dropless ocular therapy, potentially leading to a transformation in clinical ophthalmic practice. In this review, we outline the current role of contact lenses in ocular drug delivery, focusing on materials, drug binding and preparation, concluding with a look at future developments.

BACKGROUNDOphthalmological procedures are difficult to master due to the complexity of ophthalmological skills. Simulation offers a great opportunity for unlimited practice in a controlled environment. Therefore, simulation is becoming an important part of novel medical curricula. We conducted a prospective randomized controlled study to demonstrate the effects of structured cataract surgery training on the development of eye-hand coordination. METHODSTwenty-eight medical students were randomized to experimental and control groups. Each student completed 4-week structured training on The Eyesi Ophthalmic Surgical Simulator. The control group performed one training the 1^st and the 4^th week of the study (2 training sessions) and the experimental group completed one training each week of the study (4 training sessions). Every training was composed of 5 different tasks (3 abstract and 2 clinical). In task 1 students practiced basic instrument navigation and in task 2 microsurgical forceps manipulation. In task 3 they performed antitremor training. In clinical tasks, students performed capsulorhexis with premade flap in task 4. In task 5 they had to create a flap themselves. RESULTSThere was no statistical difference in performance between the groups on the first training. Control group improved their score for 16.6 % on their last (second) training and experimental group improved their score for 38.7 % on their last (fourth) training.Comparing last trainings, control group improved their result in tasks 1 and 2, whereas experimental group improved their result in all tasks.CONCLUSIONSWe showed that structured training on a cataract surgery simulator improves students’ microsurgical skills. Both groups improved their performance on the last training. Experimental group with more repetitions surpassed control group with fewer training sessions. Two training sessions were enough to achieve significant improvement in abstract tasks only. However, four repetitions were enough to significantly improve in all tasks. Our study certifies the positive impact of simulator training on microsurgical skills needed in cataract surgery. Furthermore, it shows that such skills could be achieved in students with no preceding cataract training in vivo.