Immediately sequential bilateral cataract surgery (ISBCS) is a highly contended issue in ophthalmology, mainly due to the risk of bilateral endophthalmitis and financial penalties that many ophthalmologists face when performing simultaneous cataract surgeries. The purpose of this review is to understand the current status of the knowledge of ISBCS, mainly its benefits and risks and how they compare with the standard of care, delayed sequential bilateral cataract surgery. Evidence, although limited, increasingly supports ISBCS for providing faster rehabilitation, improved visual outcomes, and cost and time savings. Evidence does not support the fear of bilateral endophthalmitis resulting from the simultaneous procedure. However, stronger and greater evidence is needed before ISBCSs can be considered the standard of care. Where ISBCS can potentially create the most beneficial impact is in public eye health programmes in developing countries, but this has not yet been explored.

The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-based surgical training simulator as the centerpiece of a scalable, comprehensive training system for manual small-incision cataract surgery.

The primary cause of failure in glaucoma filtration surgery is fibroblastic proliferation and subconjunctival fibrosis at the bleb site resulting in decreased aqueous flow. We evaluated New Zealand white rabbits in a masked, placebo controlled pilot study to determine the potential reduction of episcleral fibrosis at the surgical bleb site utilizing 0.3 mis of: balanced salt solution (n = 11); an Inert gel delivery vehicle (n=13); the gel delivery vehicle with incorporated recombinant tissue plasminogen activator (tpa; n=14), 1 mg/ml. Statistical analysis of computer assisted area measurements from multiple histologie sections demonstrated a significant decrease in episcleral fibrosis in the t-PA group as compared to the two other groups (p < 0.05). Results from the t-PA group did not demonstrate an effect on intraocular pressure. There was no clinical evidence of toxicity or healing complications in the t-PA group. 9

Standardization of terminologies and methods is increasingly important in all fields including ophthalmology, especially currently when research and new technology are rapidly driving improvements in medicine. This review highlights the range of notations used by vision care professionals around the world for vision measurement, and the challenges resulting from this practice. The global community is urged to move toward a uniform standard.

The world of virtual reality‐based training is gradually reaching into the field of ophthalmology, but the methodology for creating high‐fidelity simulation tools is largely unexplored and slowly catching up with the curve of available technology. This paper explores many of the challenges involved in the development of new technology in the hopes of encouraging research and development.