APR 2013

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

Issue link: https://digital.eyeworld.org/i/119916

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Page 70 of 82

68 EW International April 2013 Patients continued from page 67 Eye Clinic, St. Lukes Medical Center, Bonifacio Global City, Philippines. "Those candidates are patients who have had intracapsular cataract extraction and have no capsule left." In the U.S., children in need of ophthalmic care would see a pediatric ophthalmologist. Many children in the Philippines are cared for by general ophthalmologists outside of metropolitan areas. Economic considerations may limit the ability of a family to seek the initial care of a subspecialist. In the event that congenital cataract surgery ends with complications in the hands of a non-subspecialist—which does indeed happen —children then are referred to subspecialists for secondary lens implantation. Some children who are referred are post-vitrectomy and have had their posterior capsules removed. Others may have damage to their anterior capsular rim, limiting the sulcus-fixated secondary lens implantation option. "They present differently all the time because of the prior surgery," Dr. Roque said. "Healing is different in each child." LET'S TALK SOLUTIONS We understand the demands you face with today's refractive cataract surgery. The A-Scan Plus Connect ofers improved ease and speed of capturing measurements. The results are more precise scans with less patient chair time. Experience the benefits of our industry's most advanced biometer. When these complicated cases present, Dr. Roque often turns to the Artisan Aphakia lens for its iris-fixation ability. These lenses are implanted well away from the endothelium. Retropupillary implantation is employed and endothelial impact is avoided, eliminating the possibility of longterm damage, Dr. Roque said. "You would like to go ahead and implant the IOL to prevent amblyopia formation," Dr. Roque said— one of the major benefits of IOL implantation at such a young age. Of course, transscleral sutured IOLs are alternatives to the Artisan Aphakia lens. "But I would rather go with the Artisan," Dr. Roque said. For an adult case, a transscleral sutured lens procedure takes at least two hours. "I haven't come across anybody who can do it in a significantly shorter period of time," Dr. Roque said of lenses implanted via scleral sutures. The Artisan Aphakia lens procedure compares very favorably, at 2530 minutes, he said. "It's far simpler and more stable," Dr. Roque said. "There's no iris dislocation of the lens into the chamber provided the techniques used are good." Few implantations Visit us at ASCRS Booth #1310 #24-4400 www.accutome.com/product/connect 3222 Phoenixville Pike, Malvern, PA 19355 USA • 800-979-2020 • 610-889-0200 • FAX 610-889-3233 • www.accutome.com One wonders, however, whether the Artisan Aphakia could be used more widely in the Philippines if more eyecare providers were aware of its benefits. Just take into account the following statistics in the Philippines, according to Dr. Roque: • Population: 100 million • Number of ophthalmologists: less than 2,000 • Percent of ophthalmologists in metropolitan areas: 70-80% • Percent of ophthalmologists in other areas: 20% • Number of ophthalmologists implanting the Artisan Aphakia: approximately 10 (assisted by one of two Ophtec-accredited surgeons) Artisan Aphakia surgeries have been performed over the last six years in the Philippines, owing to surgeries undertaken by himself and that of one other surgeon. Dr. Roque said the lenses are more widely used in South Korea. Dr. Roque said it's easy to obtain the Artisan Aphakia in the Philippines. Stocks are available in the country such that an ophthalmologist could get it within 1-2 days via pickup or courier. It's also more cost-

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