Eyeworld

World view Products that could change how you practice The official publication of the American Society of Cataract & Refractive Surgery A S C R S September 2018 Vol. 23 • No. 9 ASCRS Executive Director Steve Speares sspeares@ascrs.org Editorial Editor Amy Goldenberg amy@eyeworld.org Managing Editor Stacy Jablonski stacy@eyeworld.org Senior Staff Writer/Digital Editor Ellen Stodola ellen@eyeworld.org Senior Staff Writer Liz Hillman liz@eyeworld.org Production Graphic Designer Julio Guerrero julio@eyeworld.org Graphic Design Assistant Susan Steury susan@eyeworld.org Production Manager Cathy Stern cathy@eyeworld.org Editorial Production Assistant Taylor Wise taylor@eyeworld.org Contributing Writers Stefanie Petrou Binder, MD Berlin, Germany Vanessa Caceres Bradenton, Florida Rich Daly Arlington, Virginia Lauren Lipuma Washington, D.C. Michelle Stephenson Roanoke, Virginia Senior Contributing Writer 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 Paul Zelin paul@eyeworld.org Molly Phillips molly@eyeworld.org Classified Sales Cathy Stern cathy@eyeworld.org EyeWorld Special Projects and Events Jessica Donohoe jessica@eyeworld.org Shelly Dixon shelly@eyeworld.org Anne Le anne@eyeworld.org ASCRS Publisher: EyeWorld (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; 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 22033-4055; 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 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org Copyright 2018, ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055. 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 22033-4055; 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 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: cathy@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. P U B L I S H I N G S T A F F I think ophthalmology is one of the most exciting specialties in medicine because of the constant innovations in helping patients with what many consider the most precious sense, their vision. The focus of this issue of EyeWorld is to teach ophthalmic surgeons about possible game changers in technologies, ones that could impact practices in significant ways. The Light Adjustable Lens (RxSight, Aliso Viejo, California) is FDA approved, and commercial release is around the corner. EyeWorld spoke with David Chang, MD, Robert Maloney, MD, John Doane, MD, and Kevin Waltz, MD, all renowned experts in this surgical arena, to discuss the mechanism of light adjustability and its accuracy, permanency, and high rate of patient satisfac- tion. I was an investigator in the U.S. clinical trials, and I think this technol- ogy is poised to benefit many. Another recently approved technology is the TrueTear neurostimulation device (Allergan, Dublin, Ireland), which helps dry eye patients use their body's natural mechanisms to produce more tears. William Faulkner, MD, beautifully explains TrueTear's ability to stimulate the production of physi- ologic tears. Thank you also to John Sheppard, MD, Stephen Pflugfelder, MD, and Richard Lewis, MD, for teaching us more about the neurostimu- lation mechanism of action and how it can uniquely increase all three vital layers of the tear film. This lubrication, in a uniquely physiologic fashion, is a step forward for dry eye patients. Glaucoma affects many for multiple reasons including the side effects of drops and surgery and the difficulty of titrating therapy to individual needs. Balance Goggles (Equinox, Sioux Falls, South Dakota) are an exciting technology being developed to noninvasively and precisely lower IOP on demand. Thank you to John Berdahl, MD, Russell Swan, MD, and Malik Kahook, MD, for teaching us how these goggles work to lower IOP and why CSF pressure matters. I think it is exciting that these goggles can potentially treat glaucoma alone or in combination with medical and surgical therapy. Tremendous research has been put into furthering vision and technolo- gy options for cataract surgery patients. Cataract and refractive surgery have come together in premium implant surgery. It has been said that besides the implant calculation itself, the capsulotomy plays the most important role in visual and refractive outcomes because of its influence on effective lens po- sition. Dr. Waltz, Dr. Swan, and Florian Kretz, MD, along with co-inventor David Sretavan, MD, teach us about the Zepto capsulotomy system (Myno- sys Cellular Devices, Fremont, California). How Zepto fits in a world domi- nated by manual capsulorhexis with a smaller role played by femtosecond laser-created capsulotomies is discussed. I think there is room for all three, and this article helps us further our knowledge on how Zepto is growing in our world of cataract surgery. Anesthesia in cataract surgery is a subject of great interest to our surgical patients. Patients interested in options other than having an IV are excited to hear about MKO Melt (Imprimis Pharmaceuticals, San Diego). Dr. Berdahl, Mike Greenwood, MD, and Chris Bender, CRNA, share what the MKO Melt consists of, its advantages/disadvantages, and how their patients' satis- faction with their cataract surgery journey has been impacted in a positive way. EyeWorld salutes the physicians who have contributed to this issue and thanks them for their expertise and willingness to share their stories. I hope you enjoy reading what I consider one of the most exciting issues of EyeWorld that I have had the honor of being involved with. EW Vance Thompson, MD, Refractive editor

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