Eyeworld

DEC 2012

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

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52 EW MEETING REPORTER Reporting live from AAO/APAO 2012, Chicago December 2012 mean sphere, as well as the mean pre-op cylinder. ���The most surprising aspect of the results that we found was in the cylinder correction,��� Dr. Schallhorn said, explaining that the new results showed better cylinder correction outcomes with a tighter distribution. ���The standard deviation is tighter than it is for the current [wavefront-guided] treatment,��� he said. The general conclusion from the results was that ���initial results of wavefront-guided LASIK using a new aberrometer to correct hyperopia and myopia with a large range of astigmatism is favorable,��� and that ���significantly more treatments with longer follow-up is progressing,��� according to the abstract. Dr. Schallhorn said the initial evaluation of the new wavefrontguided procedure shows similar refractive predictability to current treatments but superior cylinder correction and a slightly higher level of patient satisfaction. The aberrometer is still under development. Editors��� note: Dr. Schallhorn has financial interests with Abbott Medical Optics, Allergan, and Optical Express. Multiple options available to treat post-LVC ectasia Editors��� note: This Meeting Reporter contains original reporting by the EyeWorld news team from AAO/APAO 2012, Chicago. Different modalities offer different methods to treat post-laser vision correction ectasia. ���Management of post-LASIK ectasia with crosslinking, Intacs [Addition Technology, Des Plaines, Ill.], PRK, and phakic IOLs is safe, effective, and with good predictability,��� said Jan A. Venter, M.D., medical director, Optical Express, London. ���[A total of] 94% of 49 ectatic eyes achieved a BCVA of 20/25 or better and 73.5% had 20/25 or better UCVA.��� ���Early diagnosis is very important to achieving the best clinical outcomes,��� Dr. Venter said. Dr. Venter conducted a retrospective review of ectasia in 58 patients who had undergone LASIK or LASEK with a follow-up of 1 year to 4.5 years. All patients underwent corneal crosslinking (CXL). View this video at www.EWrePlay.org/ AAO2012 Bonnie An Henderson, M.D., Boston Eye Surgery and Laser Center, Dover, Mass., gives highlights of the ���Pearls and Pitfalls of Toric IOLs��� session. Marking and corneal astigmatism are becoming more important as surgeons use more and more toric IOLs, Dr. Henderson said. There was a minimum of 12 months following CXL for confirmation of topography/refraction stability. Following that time, patients underwent further procedures/ corrections to correct the remaining refractive error. Patients with irregular astigmatism and a BCVA of 20/30 or less had Intacs implanted (19 cases); patients with a BCVA of 20/25 or better underwent either PRK (14 cases) or phakic IOL implantation (16 cases). Nine cases did not need further surgery after CXL, instead using options including spectacles or lamellar graft. Editors��� note: Dr. Venter has no financial interests related to his comments. Study: Phakic IOL explantation surgery safe, effective, reversible refractive approach Clinical results and refractive outcomes were promising in many cases of explanted phakic IOLs, according to a study author. ���Phakic IOL explantation surgery is an effective and safe procedure, and also the clinical and refractive outcomes were excellent in most of the cases, and the [phakic IOL exchange, bilensectomy, or other associated refractive procedure] techniques showed to be effective in these results,��� said Felipe A. Soria, M.D., Vissum Corporation, Alicante, Spain. In the consecutive, retrospective, observational, multicenter series, 140 cases of phakic IOL explanations in Spain were reviewed. A total of 61.4% of four types of anglesupported IOLs were explanted; 30.8% of two types of posterior chamber IOLs were explanted; and 7.8% of three types of iris-fixated IOLs were explanted. The main reason for explantation was cataract, followed by endothelial cell loss and other complications, Dr. Soria said. The explantation procedures performed were simple explantation surgery, bilensectomy, phakic IOL exchange, and penetrating keratoplasty. ���As far as we know, it���s the largest case study ever reported, so it makes the study highly reliable to evaluate the outcomes of phakic IOL explantation,��� Dr. Soria said. Editors��� note: Dr. Soria has no financial interests related to his comments. Genetic testing remains controversial for AMD In a pro-con discussion on the merits of genetic testing for age-related macular degeneration (AMD), Mark S. Blumenkranz, M.D., Palo Alto, Calif., said there were several arguments in favor of genetic testing, but added the caveat that none of the tests has been shown to be cost effective.

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