EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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62 EW MEETING REPORTER June 2012 Ophthalmology continued from page 61 Reporting live from the 2012 Ophthalmology Innovation Summit, Chicago none of the devices are currently ap- proved in the U.S., "glaucoma med- ications will be in jeopardy in the very near future as some of these procedures become available," said Eric Donnenfeld, M.D., Long Island, N.Y. "I am very excited about [micro-] invasive glaucoma surgery because I think it has a great future," said Richard L. Lindstrom, M.D., founder, Minnesota Eye Consult- ants, Minneapolis. During the panel discussion on MIGS, Dr. Donnenfeld gave his thoughts on the impact MIGS would have on ophthalmology as a whole. "For the first time glaucoma will go mainstream," he said. "Ophthalmol- ogists in general have viewed glau- coma as a subspecialty that's been isolated because the risk-reward ratio for performing glaucoma procedures wasn't something that the average ophthalmologist was comfortable with." Because of that, glaucoma has been isolated into the hands of glau- coma specialists. But the "elegance and precision of these new MIGS procedures opens up the realm of glaucoma surgery to the average ophthalmologist," Dr. Donnenfeld said. "I think this is going to become the standard of care and may change the way we look at glaucoma." Predicting the future of cataract surgery www.ophthalmologysummit.com/ ascrs/presentation.html View video from OIS@ASCRS or PowerPoints (pass word OISASCRS) Editors' note: This Meeting Reporter contains original reporting by the EyeWorld news team from the 2012 Ophthalmology Innovation Summit, Chicago. The second half of OIS@ASCRS focused on enhancing refractive outcomes in cataract surgery. Jack T. Holladay, M.D., clinical pro- fessor of ophthalmology, Baylor College of Medicine, Houston, began the session with an overview of the unmet need and size of the opportunity in cataract surgery. "In 2007, we did about 3 mil- lion cataract surgeries," he said. "And in 2011 we did about 3.31 million cataract surgeries." Ten years ago, 72 was the average age of the cataract surgery patient. But because of the improve- ments in cataract surgery over the last decade, that age has dropped to 66. Bill Link talks about the innovation cycle to a full house Source: Convention Photo by Jeff Orlando "The age is becoming younger and the severity of the cataract is be- coming less because the success and safety of the operation is so good," he said. Within 5 years, Dr. Holladay expects cataract surgeons to see be- tween a 7% and 16% increase in sur- geries. In 10 years, he expects there to be a 20-34% increase in surgical volume. Dr. Holladay pointed out a number of areas that need improv- ing over the next 5 years or so. For example, the brightness acuity tester, which Dr. Holladay invented in 1976, is outdated. "We have newer instruments like the one from Visiometrics (Terrassa, Spain) called the OQAS [Optical Quality Analysis System], now the HD Analyzer, that measures light scatter," he said. "Wavefront doesn't measure that, visual acuity doesn't measure that, contrast sensi- tivity doesn't measure that, but light scatter, it turns out, is the one thing that is the most highly correlated with cataract severity and the dis- ability it achieves in a patient." Dr. Holladay believes cataract surgeons in the future will see more devices that objectively measure the disability of the patient as a result of the cataract. He gave an overview of the components of cataract surgery, which he defined as surgical tech- niques, the IOL calculation hitting the target refraction, and improve- ments in the IOL itself. He also elab- orated on what goes into cataract surgery, which includes making the incision, phaco, IOL insertion, and intraoperative refraction.