Eyeworld

MAR 2012

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

Issue link: https://digital.eyeworld.org/i/78716

Contents of this Issue

Navigation

Page 11 of 167

World view The "art" of refractive surgery I Kerry Solomon, M.D., refractive editor t's often stated that medicine is as much art as science. This is especially true with elec- tive procedures. Patients have high expecta- tions and misconceptions about what we can and cannot deliver to them. Patients believe that in today's world, the unthinkable is possible. Physicians have to talk patients down from their expectations and focus on what is possible. In practicing the "art of medicine," they have to evaluate patients' motivations and goals and ground their expectations. They also have to prepare patients for possible side effects and complications, which, while rare, do occur. The focus of this month's issue is "Refractive" and encompasses both cataract and cornea refractive subspecialties. In the cataract area, we focus on two topics. The first is the femtosecond laser for cataract surgery. Since its introduction after FDA approval last year, there have been approxi- mately 8,000 femtosecond procedures performed globally. More than 500 surgeons from 20 countries have been trained and are using this technol- ogy in their daily practices. In this month's issue, we asked surgeons from around the globe how they integrated this new technology into their prac- tices and how well accepted it has been by their patients. The second refractive cataract focus is refractive outcomes. While this topic may seem unimportant, I think it's one of the most important things we do and can improve. It's interesting to me that most surgeons are not as aware as they should be about how accurate cataract surgery is in 2012. The Monthly Pulse Survey results illustrate this. The overwhelming major- ity of respondents feel they achieve an outcome within 0.5 D more than 90% of the time. The world literature and current databases suggest the majority of outcomes are 55-65% of the time within 0.5 D. In fact, if everything is done as judiciously as possible, with all of the latest technol- ogy, optimizing surgeon factors, the data can be improved to 80-84%. This is the limitation of modern diagnostic technology and current surgical techniques. Given the realities of our refractive outcomes after cataract surgery, it's important for surgeons to ground their expectations in order to ground patients' expectations. We are going to be outside of where we and perhaps our patients want their vision to be 15-25% of the time. As refractive cataract surgeons, we must recognize this and prepare ourselves, and our patients, for the possibility that enhancements might be needed for standard and premium procedures alike. The "art" of refractive cataract surgery involves the education of all patients about what is and is not realistic. On the corneal refractive front, two of this month's articles focus on side effects and complications. While rare, these can often be avoided or treated successfully. We discuss the issue of corneal neuralgia, a rare but debilitating condition of corneal pain after corneal refractive surgery. The military has some insight into this condition, and this article provides some useful thoughts on screening to identify patients at risk. Also discussed is the suggested etiology, means of diagnosis, and treatment options for this rare condition. A second corneal refractive article focuses an epithelial ingrowth. The physicians interviewed provide a great review of the etiologies, diagnostic techniques, and treatment options for this fairly uncommon but treatable complication. Finally, no corneal refractive issue would be complete without a look at the technologies of the future—the "science" of refractive surgery. Physicians discuss topographic wavefront-guided LASIK treatments, which offer promise for irregular corneas and perhaps all future LASIK patients. I hope you enjoy this issue and benefit from the "art" and "science" of modern refractive cataract and corneal surgery. Kerry Solomon, M.D., refractive editor Publisher Donald R. Long dlong@eyeworld.org Editorial Editor Stephanie Graham stephanie@eyeworld.org Assistant Editor Stacy Majewicz smajewicz@eyeworld.org EyeWorld Staff Writers Faith Hayden faith@eyeworld.org Jena Passut jena@eyeworld.org Production Graphic Designer Julio Guerrero jguerrero@eyeworld.org Production Manager Cathy Stern cstern@eyeworld.org 703-383-5702 Production Assistant Karen Salerni ksalerni@eyeworld.org Contributing Editors Vanessa Caceres Lakeland, Florida Michelle Dalton Reading, Pennsylvania Rich Daly Arlington, Virginia ASC RS The official publication of the American Society of Cataract & Refractive Surgery March 2012 Volume 17 • No. 3 PUBLISHING STAFF Enette Ngoei Singapore Matt Young Malaysia Senior Contributing Editor Maxine Lipner Nyack, New York Advertising Sales ASCRSMedia 4000 Legato Road Suite 700 Fairfax, VA 22033 703-591-2220 fax: 703-591-0614 eyeworld@eyeworld.org www.eyeworld.org Advertising Sales Managers Jeff Brownstein jbrownstein@eyeworld.org 703-788-5745 Paul Zelin pzelin@eyeworld.org 703-383-5729 Classified Sales Cathy Stern cstern@eyeworld.org 703-383-5702 EyeWorld Special Projects and Events Jessica Donohoe jdonohoe@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 22033-4003; 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 22033-4003; 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 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. Copyright 2012, ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003. 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. 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 22033-4003; 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 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: cstern@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.

Articles in this issue

Links on this page

Archives of this issue

view archives of Eyeworld - MAR 2012