Eyeworld

SEP 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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A S C R S World view Refractive challenges require out-of-the-box thinking The official publication of the American Society of Cataract & Refractive Surgery September 2013 Volume 18 • No. 9 P U B L I S H I N G   S TA F F "We cannot solve a problem by using the same kind of thinking we used when we created it." –Albert Einstein T his issue focuses on refractive challenges and innovations. This area requires out-ofthe-box thinking. We all face challenges from time to time, and figuring out the solution is part of the learning cycle. Kerry Solomon, MD, There are multiple solutions to a given refractive refractive editor challenge. Identifying issues and then discussing a variety of solutions with peers helps all of us when we inevitably face challenges. Diagnostic curve balls: What to do when our diagnostic instruments, such as corneal topography, show a warning sign? Y. Ralph Chu, MD, Carlos Buznego, MD, Vance Thompson, MD, Uday Devgan, MD, and Lou Probst, MD, discuss this very common dilemma that all refractive surgeons face. Free caps are a known but infrequent complication of LASIK surgery. How should this challenge be handled? How do we proceed after the free cap has occurred? Continue with LASIK? Reposition the free cap and return at a later time for LASIK with a deeper cut? Return later for PRK? Consider phakic IOLs and refractive lens exchange at a later time? Neel Desai, MD, presents a case he encountered of a free cap and shares how he expertly managed it. James Salz, MD, and Lou Probst, MD, discuss the issues and treatment options. Refractive amblyopia in the setting of a posterior polar cataract with progressively decreasing vision: John Berdahl, MD, presents such a case with pre-existing astigmatism that the patient wants to have corrected. How can this case be handled and what do you do in the event of a posterior capsular tear (a known and not infrequent occurrence in the setting of posterior polar cataracts)? Dr. Berdahl shares his thought process and skilled management of this refractive challenge. Gary Wortz, MD, William Wiley, MD, and Sam Garg, MD, discuss the issues surrounding posterior polar cataracts, treatment options, and management of astigmatism in the setting of an open posterior capsule. Innovation requires new thinking to help solve issues we commonly encounter. Stephen Lane, MD, and Louis Nichamin, MD, discuss a new innovation, the Verion. This technology has the potential to facilitate surgical planning for refractive cataract surgery and, through integration with the femtosecond laser and operating microscope, improve the accuracy of the execution of the surgical plan. The implications are the potential for improved refractive outcomes, something patients expect and surgeons embrace. I hope you enjoy this issue of EyeWorld, and thanks to all of the physicians above for taking the time to present and discuss these important issues. Kerry Solomon, MD, refractive editor Publisher Matt Young don@eyeworld.org Enette Ngoei Donald R. Long Editorial Editor Jena Passut jena@eyeworld.org Managing Editor Stacy Majewicz stacy@eyeworld.org Senior Staff Writer Erin Boyle erin@eyeworld.org Malaysia Dublin Rich Daly Arlington, Virginia Senior Contributing Writer Maxine Lipner Nyack, New York Advertising Sales ASCRSMedia 4000 Legato Road Suite 700 Fairfax, VA 22033 ellen@eyeworld.org 703-591-2220 fax: 703-591-0614 eyeworld@eyeworld.org www.eyeworld.org Production Advertising Sales Graphic Designer Jeff Brownstein Julio Guerrero jeff@eyeworld.org julio@eyeworld.org 703-788-5745 Production Manager Paul Zelin Staff Writer Ellen Stodola Cathy Stern cathy@eyeworld.org 703-383-5702 Production Assistant Daniela Galeano daniela@eyeworld.org Contributing Writers Vanessa Caceres Lakeland, Florida Michelle Dalton Reading, Pennsylvania paul@eyeworld.org 703-383-5729 Classified Sales Cathy Stern cathy@eyeworld.org 703-383-5702 EyeWorld Special Projects and Events Jessica Donohoe jessica@eyeworld.org 703-591-2220 ASCRS Publisher: EYEWORLD (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; telephone: 703-591-2220; fax: 703-591-0614. Printed in the U.S. Editorial Offices: EYEWORLD News Service, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. Advertising Offices: ASCRSMedia, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. Copyright 2013, ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. Letters to the editor and other unsolicited material are assumed intended for publication and are subject to editorial review and acceptance. Subscriptions: Requests should be addressed to the publisher. Annual subscription prices: Individual: 1 year, $120; 2 years, $220; 3 years, $320. Institutional: 1 year, $250; 2 years, $330; 3 years, $425. Foreign: 1 year, $240, 2 years $470, 3 years, $700. Back copies: Subject to availability. Contact the publisher. Cost per copy is $15; $30 foreign. All orders for individual or back copies must be accompanied by payment. Send us your favorite APP! Have a favorite app that helps you with business or personal activities? Email stacy@eyeworld.org with the app name and how it helped you. Apps selected will be published in Ophthalmology Business and their submitters will receive a $50 iTunes card. You may be selected for a brief interview. Requests to reprint, use, or republish: Requests to reprint or use material published herein should be made in writing only to Cathy Stern, EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. EYEWORLD reprints: To order reprints of material published in EYEWORLD, contact Cathy Stern, EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: cathy@eyeworld.org or your salesperson. Change of address: Notice should be sent to the publisher six weeks in advance of effective date. Include old and new addresses and label from recent issue. The publisher cannot accept responsibility for undelivered copies. POSTMASTER: Send change of address to EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033. Periodical postage paid at Fairfax, VA 22033 and at additional mailing offices. The ideas and opinions expressed in EYEWORLD do not necessarily reflect those of the editors, publisher, or its advertisers.

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