EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/115557
A S C R S World view Worlds colliding H ow many times have we, as cataract surgeons, heard the question, "Do you use lasers in cataract surgery?" With the introduction of femto cataract surgery, the worlds of refractive surgery and intraocular lens surgery have collided. Refractive cataract surgery was previously achieved with toric and presbyopia-correcting IOLs. In this issue, Stephen S. Lane, M.D., Jay Pepose, Bonnie Henderson, M.D., M.D., Douglas D. Koch, M.D., Robert Crotty, O.D., and R. Bruce Wallace III, M.D., share their cataract editor perspectives on the past 10 years since the first premium IOL was approved. What have they learned and what have they changed over this past decade? Have they become better at calculating the power of the lens and minimizing the residual refractive error? Terry Kim, M.D., John Berdahl, M.D., Brad Black, M.D., and Deepinder K. Dhaliwal, M.D., share their secrets in managing postop refractive surprises in the setting of a premium IOL. They discuss accurate measurements, the benefits of intraoperative aberrometry, and importance of maximizing the ocular surface. While the far majority of surgeons use premium IOLs as the only means of offering refractive cataract surgery, the use of femtosecond lasers continue to rise. Even for those who are critical of this new technology, it is hard to ignore the growing prevalence of the femtosecond laser. With hundreds of surgeons using the femtosecond laser, the debate surrounding this technology is just as fervent now as it was at the launch in 2011. Zoltan Nagy, M.D., William W. Culbertson, M.D., and Neil J. Friedman, M.D., who use the femtosecond laser, believe that this is the wave of the future for cataract surgeries due to improved safety and accuracy. Although the incorporation of the laser can be challenging to the normal flow in the surgical center, Michael J. Endl, M.D., states that his patients have accepted the disruption in flow because of the benefits of the laser. While the doctors warn that the femtosecond laser is not for every case, they believe that it is a useful tool that will gain importance in the future. Once the decision to purchase a femtosecond laser is made, there are other considerations. Can the same femtosecond laser be used for LASIK as well as for cataract surgery? Do the conveniences of a single laser for both uses trump the possible tradeoffs of a combined platform? In this issue, Calvin W. Roberts, M.D. (Bausch + Lomb), Seba Leoni (Alcon), Mark J. Forchette (OptiMedica), and Nick T. Curtis (LensAR) debate the advantages and disadvantages of having a combined platform. Regardless of whether the same laser is used for both corneal and cataract surgery, the subject of proper billing/reimbursement for femtosecond cataract surgery remains an important topic. In their practices, Karl Stonecipher, M.D., and Steven Vold, M.D., agree that patients are not to be charged for the use of the femtosecond laser for cataract surgery but find that most patients who choose to have a refractive IOL or astigmatism correction also elect to have the femtosecond laser option. Additional consent forms that include the risks/benefits of the laser are recommended. Now when patients ask "Do you use lasers in cataract surgery?," we can finally reply that we do. Bonnie Henderson, M.D., cataract editor The official publication of the American Society of Cataract & Refractive Surgery March 2013 Volume 18 • No. 3 P U B L I S H I N G S TA F F Publisher Enette Ngoei don@eyeworld.org Matt Young Donald R. 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