EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78708
June 2012 EW MEETING REPORTER 63 With femto-cataract surgery, the cataract surgeon makes a primary in- cision, a secondary incision to put the second tool in, two arcuate inci- sions to eliminate the corneal astig- matism, and a capsulorhexis that is "absolutely circular," Dr. Holladay said. Finally, the nucleus is softened for easier cataract extraction. Dr. Holladay predicts that within 5 years, all surgeons will be using the femtosecond laser for cataract surgery because of the accu- racy (being reported by current users) and patients' perception of laser cataract surgery versus the knife. Cataract surgeons are still strug- gling with toric IOL calculations, which aren't exact, he said. That's because toric IOL calculators use a constant to calculate the toric lens power. But it's not constant. "More and more calculators over the next year or two will be- come exact and give us the exact value for the toricity of an IOL," he said. This is very important because the number of premium IOLs im- planted has reached an all-time high of 14.5% of all IOL surgeries. "The biggest increase in the pre- mium channel lenses is toric IOLs, and it's because of shared billing," he said. "The doctor does not have to bill Medicare for that; he can up- charge the patient and charge for the correction of that astigmatism, and as a result we're seeing premium channel IOLs increasing dramati- cally." Dr. Holladay concluded with his predictions for cataract surgery in the next 5 years, saying that cataract surgery volume will continue to in- crease; femtosecond and short-wave lasers will be the predominate tech- nique for surgery; newer IOL calcula- tion formulas, adjustable IOLs, and intraoperative refraction will elimi- nate astigmatic and some higher order aberrations; and IOLs will ac- commodate, eliminating presbyopia with either electrical or mechanical means that will automatically adjust the power so there is no loss of con- trast/halos or nighttime dysphotop- sias. O The Op NOVEMBER 8, 2012 Chicago Marriott Downtown Magnifi cent Mile advancement of ophthalmic products, drugs, and devices. 2011 Attendee Demographics e Ophthalmology In novation Summit (OIS ) unites leaders i adv 625 Delegates from 31 States and 17 Countries Represen ted the Following Categories: rs in the Te Testimonials Focusing on premium IOLs Doug Koch, M.D., professor and the Allen, Mosbacher, and Law Chair in Ophthalmology, Cullen Eye Insti- tute, Baylor College of Medicine, discussed the current state and future impact of premium IOLs. The market for presbyopia-cor- recting IOLs has been flat since 2008. In fact, it's only grown 1% from 2005 to 2012. Why? "Surgeons don't have confi- dence in the outcomes of multifo- cals," Dr. Koch said. "There's some concerns about the quality of vision and they're not prepared to deal with the patient complaints." There's also the issue of the ac- commodating IOL unpredictability and an overall lack of confidence in surgical precision, which is required to have these lenses perform well. "No one likes to do an IOL ex- change," he said. Dr. Koch thinks toric IOLs have "cannibalized" the premium IOL market because doctors can up- continued on page 64 4TH ANNUAL Summit C hairman: Meeting Co-Chairs: Emmett Cunningham, Jr., MD Partner Clarus Ventures re Advisory Board Members: MD,, PhDD, MPH Gilbert Kliman, MD Managing D Managing Director InterWest Partners William J. Link, PhD Managing Director e Versant Ventures ersan re Anthony y P. Adamis, MD VPP,, G lobal H ead of Ophthalmology Genentech Mark Blumenkranz, MD Professor & Chairman, Department of Ophthalmology f Stanford University REGISTER TODA Y RECEIVE $100 OFF! David A. Karcher Executive Director ASCRS Michael Kaschke, MD Preresident & CEO Carl Zeiss A eiss AG Richard Lindstrom, MD Founder & MD Attending Surgeon Minnesota Eye Consultants K. Angela Macfarlane President & CEO ForSight Labs re ane Sabri Markabi, MD Chief Medical Officer Sr .Vice Preresident R&D Alcon Laboratories, Inc. Jim Mazzo Prer esident Abbott Medical Optics Inc. Senior V ice Prre Abbott L esident bbott Laboratories or Use D iscount Code: EYEWORLD * Y Your r registrra ation t type is contingent upon veron v veriification b by IBF * *Disccount is not combinable with anny other pr er prromotional offffomotional offeers. * Produc David W. Parke II, MD Executive VPP,, CEO , MD American Academy of Ophthalmology Samir Patel, MD President & CEO OphthoTech oT Te Calvin Roberts, MD Executive VPP, CMO Bausch and Lomb E llen Strahlman, MD,, MHSc Sr . VPP,, Office of the CEO GlaxoSmithKline e of the CEO Scott M. Whitcup, MD EVPP, R&D and CSO Allergan, Inc. duced B y: Brook Byyers Partner Kleiner Perk ins Caufield & Byers Tom Dunlapp President and CEO HOYA S gic YA urgical Optics Eugene DeJuan, MD Partner neF g OneFocus Ventures Professor, UCSF Ve r re es D David Guyer, MD Partner fe SV Life Sciences cienc FOR MORE INFORMATION AND TO REGISTER VISIT: WWW.OISAAO.COM