EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78719
World view The colorful spectrum of IOLs W Bonnie An Henderson, M.D., cataract editor hen I was a child, 100 years ago, soccer players wore two types of cleats: black with white stripes or solid black. No serious player would ever be caught wearing anything else. Now when I watch my son's soc- cer games, the soccer cleats are neon orange, blue, purple, or a combination of bright colors. The same holds true for IOLs. Even with modern phacoemulsification cataract surgery, patients' choices of IOLs were limited to a few options until the last decade. Over the past several years, with the introduction of astigmatism- correcting and presbyopia-correcting IOLs, patients now have a dizzying amount of options. Coupled with new features such as asphericity and short wavelength light filtration, the surgeon must stay abreast of the newest technologies in order to properly advise the patient. In this issue: 1. We highlight updates for accommodating IOLs. Since new IOLs are often available elsewhere in the world many years before they become available in the U.S., we asked the implanting surgeons about their ex- periences with these new lenses. 2. The line between cataract surgery and refractive surgery is indeed blurred. Patients are increasingly becoming more demanding of spec- tacle independence after cataract surgery. A residual post-operative re- fractive error is becoming less acceptable everywhere and not just in highly oversaturated urban areas. Understanding surgically induced astigmatism (SIA) is important in planning and predicting post-opera- tive refractive error. Unless a surgeon knows his/her own induced astigmatism from the cataract incision, it is difficult to accurately pre- dict the residual refractive error. The doctors interviewed in this article describe how best to calculate SIA. 3. Whether from trauma or pseudoexfoliation, dislocated IOLs are diffi- cult to manage. Should the IOL be removed anteriorly or posteriorly? Should the secondary IOL be sutured, glued, or placed in the anterior chamber? Surgeons give their advice for removing and replacing an IOL. 4. Corneal laser refractive surgery is arguably one of the most prominent innovations in anterior segment surgery. However, not everyone is a candidate for corneal laser surgery. For patients with a high degree of myopia or hyperopia, a different alternative is necessary. Phakic IOLs have been successful for those patients with extreme amounts of re- fractive error. In this article, surgeons describe the pros and cons of the different phakic IOLs. 5. Historically, presbyopia correction has been focused on IOLs, corneal surgery, and scleral expansion. A unique technology is being created to use autofocus electrical technology to change the focal point inside the eye. ELENZA (Roanoke, Va.) is creating a new type of IOL that will allow pseudoaccommodation with the assistance of a battery-operated intraocular mechanism. So it is time to reconsider the standard black with white stripes and lace up with the newest colorful spectrum of IOLs. However, as with any type of new athletic gear, it is best to educate yourself and start slowly. Bonnie An Henderson, M.D., cataract 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 The official publication of the American Society of Cataract & Refractive Surgery February 2012 Volume 17 • No. 2 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 ASC RS 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. 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