EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78716
March 2012 VISIT GEUDER AT THE ASCRS IN CHICAGO BOOTH NO. 821! T MARK What's popular in South Korea? There's a lot of interest in SUPRACOR (Technolas Perfect Vision, Munich, Germany), an excimer laser presbyopia procedure. Dr. Tchah believes that procedure still needs refinement, however. "SUPRACOR is working now, but the indication is narrow," Dr. Tchah said. "There's also interest in clear lens extraction and multifocal IOLs, but most doctors still treat pa- tients with monovision. I also feel refractive lens exchange [RLE] is a little bit too invasive." Nonetheless, RLE is being per- formed in younger and younger pa- tients—precisely because of the presbyopia-correcting lenses avail- able, said Chul Young Choi, M.D., assistant professor, School of Medi- cine, Sungkyunkwan University, and in practice, Cornea & Refractive Surgery Services, ophthalmology department, Kangbuk Samsung Hospital, Seoul. "With the aid of presbyopic IOLs, refractive lens exchange has tremendously increased in cases, especially in relatively young patients, but traditional clear lens exchange using conventional IOLs has decreased significantly," Dr. Choi said. Monovision in Korea is a little different, though. "In traditional monovision, there's a difference in power be- tween the two eyes that is perhaps 2-2.5 diopters," Dr. Tchah said. "In Korea, the difference is 1-1.5 diopters between the eyes. We call it mini monovision." Dr. Tchah believes Korean peo- ple feel like they have a harder time adjusting to accommodation with the larger difference in dioptric power between eyes. Phakic IOLs for more severe my- opia also are popular—usually in patients with more than 10 D of myopia, he said. "But I do know one surgeon who puts them in even lower my- opes—like 5 or 6 diopters of my- opia," he said. "The quality of vision is better than corneal refractive sur- gery. But perhaps it is too aggressive to implant phakic IOLs in low my- opes." Another Korean ophthalmolo- gist, Dr. Choi, agreed that phakic IOLs are popular—both iris and sulcus fixation types, he said. LASIK currently is the most pop- ular excimer laser procedure, Dr. Tchah said. LASEK and surface abla- tion also are popular—perhaps more popular than in other parts of the world, he said. "Forty to 50% of corneal refrac- tive surgery at my institution is sur- face ablation," Dr. Tchah said. "The reason for that is that there was some bad publicity about LASIK 2 years ago. Since then, people worry about the LASIK procedure. Further, the LASIK procedure costs more— often with femtosecond lasers in- volved. With surface ablation, we don't need that laser. We can cut down on expense." Still, there is a lot of interest in femtosecond technology. When asked, "What are some new refractive procedures and/or technologies being used in Korea?" Dr. Choi pointed to femtosecond laser technology including INTRACOR (Technolas Perfect Vision)—an intrastromal method of presbyopic correction—and SMILE. "Moreover, femtosecond laser- assisted cataract [surgery] is waiting to launch in the near future," he said. "But some problems remain to be solved in the public medical in- surance system of Korea. Most re- fractive surgeons are adopting a wait-and-see strategy in upcoming technologies." Further, Dr. Choi sees different strategies emerging with excimer laser surgery. "Two strategies are surviving in the competitive refractive market," Dr. Choi said. "Surface ablation in- cluding PRK [photorefractive kerate- ctomy] and LASIK is one because it has the strongest advantage in the price competition. The other option is femto-LASIK, providing the many advantages of a premium option. Conventional LASIK using mechani- cal keratomes has decreased in the total number of cases because it does not have strengths in the price com- petition and premium market." EW Editors' note: The doctors mentioned have no financial interests related to this article. Contact information Tchah: hwtchah@amc.seoul.kr Choi: sashimi0@naver.com WWW.GEUDER.COM PRECISE CORNEA MARKING FOR PREMIUM TORIC IOLs · FLEXIBLE: Variable use either on slit lamp or with hand-held pendulum instrument · PRECISE: Highly accurate pre-operative marking of the fi nal torus position · EASY: Fast and reliable handling due to simple degree setting and easily readable scale rincon.de