EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/276058
Views from Asia-Pacific Haag-Streit is more than the sum of its parts. Our mission is innovation, which leads to the development of important diagnostic devices and equipment. Used by doctors in nearly every country, they're noted for accuracy, durability and engineering. It's what your patients expect, and you demand. Watch for what's coming out of Haag-Streit next. Science. Brilliance. Certainty. Octopus Surgical LENSTAR ® Reliance 800.787-5426 haag-streit-usa.com The Superior Practice. Haag-Streit Innovation Brought To Life. Reliance ® LENSTAR Octopus Surgical Octopus Science. Brilliance. Certainty demand. W and engineering. It nearly every country diagnostic devices innovation, which leads to the development of important Haag-Streit is more than the sum of its parts. Our mission is . Science. Brilliance. Certainty s coming out of Haag-Streit next. ' atch for what demand. W s what your patients expect, and you ' and engineering. It , they're noted for accuracy nearly every country and equipment. Used by doctors in diagnostic devices innovation, which leads to the development of important Haag-Streit is more than the sum of its parts. Our mission is s coming out of Haag-Streit next. s what your patients expect, and you , durability , they're noted for accuracy and equipment. Used by doctors in innovation, which leads to the development of important Haag-Streit is more than the sum of its parts. Our mission is Science. Brilliance. Certainty . Science. Brilliance. Certainty © 2 The Superior Practice. 2014 Haag-Streit USA. All Rights Reserved. The Superior Practice. I n the July 2013 issue of EyeWorld, one of the feature articles focused on performing cataract surgery in post refrac- tive surgery patients. The article surmised that because the corneas of these patients have c hanged, planning for cataract surgery is a bit more complicated. In our sister publication, EyeWorld Asia-Pacific, Cordelia Chan, MD, Singapore, and Michael Lawless, MD, Australia, shared their thoughts. Dr. Chan: In our cataract surgery p ractice today, we are encountering more patients with a prior history of laser vision correction or refractive surgery. Intraocular lens power cal- culations immediately become more complicated in these cases, as the patients' corneas have been altered from the refractive treatment, and there is a higher chance of refractive surprise. Patient counseling, education, and manage- ment of patient expectations are particularly important in these cases. Almost all patients will volun- teer the history of previous refrac- tive surgery, but there will be the occasional patient who is unaware of its relevance and fails to disclose it. Most patients who have had LASIK can be easily identified during careful examination of the cornea with the slit lamp biomicro- scope, but the occasional barely perceptible microkeratome flap or pristine cornea following surface ablation procedures may avoid de- tection and slip through the cracks. Certainly, history taking is impor- t ant in any case, but in the rare in- stance where prior cornea refractive surgery is overlooked, an astute biometry technician can alert the surgeon when unusually fat keratometry readings on routine biometry are encountered. When calculating IOL power for these cases, we have to make d o with whatever information case records show or what the patient can provide, but often no prior data is available. This makes choosing the correct IOL power a challenge. I tend to be obsessive and like run- ning multiple formulas in calculat- ing the IOL power in these cases. I find Hill's ASCRS Post-Keratorefrac- tive Intraocular Lens Power Calcula- tor particularly useful. This is an internet-based IOL power calculator that can be easily accessed through the ASCRS website. Various methods are used to calculate the IOL power here, including using pre-LASIK/ PRK, K values, surgically induced change in manifest refraction, and even no prior data. The average IOL power from these formulas is calcu- lated and computed, and using this, www.WinterUpdate.org PLAN AHEAD FOR NEXT YEAR REGISTRATION AND HOUSING IS NOW OPEN FEBRUA RY 12–15 L N OR N D F A E H N A A ND HO G P E ON A I T A R T S I E R R A E T Y X E OR N NG I S U ND HO 5 1 – 2 1 Y R A U R EB F w d Up er t n i W . w w w E G ND HO ON A I T A R T S I W OP E R S NO I g r o . e at d NG I S U ND HO N E continued on page 148 144-148 International_EW March 2014-dl2_Layout 1 3/6/14 4:18 PM Page 147