JUN 2013

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

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February 2011 June 2013 EW REFRACTIVE SURGERY 45 fort level." He added the Raindrop "probably alters the corneal curvature so there needs to be some allowance for that in the biometry, but it's along the lines of someone who has undergone hyperopic LASIK." Ongoing studies The KAMRA corneal inlay Source: AcuFocus A slit lamp image of the Presbia Flexivue Microlens under retroillumination Source: Presbia inlays are transparent. That may be an issue for some people." The KAMRA works by small aperture optics (basically a pinhole in the center of the pupil), Dr. Hovanesian said. "It does reduce light entering the eye, but it doesn't seem to be clinically problematic for patients or cause difficulty with nighttime glare or contrast." Dr. Whitman said the Raindrop allows surgeons to go about 150 microns deep, whereas the others need the inlay placed about 200 microns deep, "which we normally wouldn't be comfortable doing with LASIK." He describes the implantation technique as simply lifting the flap, looking under the microscope, and placing the inlay "as best you can" over the center of the pupil. "The Raindrop is a very forgiving inlay," he said. "If it moves 0.5 mm this way or that way it doesn't seem to affect vision." The surgery itself it short—about 5 minutes—and Dr. Whitman said within the first 10-15 minutes after surgery patients are already sitting and reading. Currently, Dr. Whitman uses a 110 micron flap for his LASIK patients, but has changed the depth in all non-domi- nant eyes to 150 microns "just in case down the road this is something the patient wants done." Patients he's discussed the procedure with tend to view the inlays as more of a lifestyle choice. "It's like Botox in terms of making them feel younger," Dr. Whitman said. Patients like the idea of the Raindrop "because it's made out of the same material as soft contact lenses, which is known as a safe material," Dr. Hovanesian said. "There are few materials that we have greater experience with than hydrogel, so people have an inherent com- …Because it's Time for Better you do. Know who's sitting in your chair in less than 1 minute: t Harvest more accurate data in less time t Understand each patient's full optical pathway t Determine refractions needing minimal correction to achieve 20/20 t Save 5-7 minutes per patient t See an additional 3+ patients each day t Give every patient more quality time t Increase optical revenue up to 30+% t Validate Rx changes and increase patient satisfaction t Optimize cataract and refractive outcomes to 20/happy t Enjoy more patient loyalty Now that's outstanding return on investment. It's about time! s TRS-5100 rapidly completes the required refraction with digital speed and accuracy. XFRA TION: WAVEFRONT OPTIMIZED REFRAXION RAC WAVEFR NT OPTIMIZED REFRA ION VEFRO V 800.874.5274 www.marco.com *Data based on national averages. In the U.S., studies are evaluating the device in near emmetropes, but outside the U.S., inlays are undergoing trials with simultaneous LASIK, Dr. Whitman said. "Once the Raindrop is approved I think you'll see a lot of surgeons combining it with LASIK," he said. "It's got the potential to change how we look at premium lens implants in the future." For instance, the age of the ideal inlay patient is precataract, so "there may be no reason to do a premium lens implant on them later on," he said. With "literally billions of presbyopes, including a good number who had prior laser surgery," corneal inlays represent a "really good option," Dr. Hovanesian said. "Inlays allow us to provide a visual experience that is as rewarding to a 45year-old as LASIK is for a 25-yearold." Inlays represent "a truly lifelong benefit. There are not too many procedures we can give our mid-40s patients that will benefit them forever," he said. But once the inlays are approved, "a whole new world is in front of us." EW Editors' note: Drs. Hovanesian, Verdoorn, and Dr. Whitman have financial interests with ReVision Optics. Dr. Waring has financial interests with AcuFocus. Contact information Hovanesian: 949-951-2020, jhovanesian@harvardeye.com Verdoon: c.verdoorn@lasikcentrum.nl Waring: 843-876-2020 Whitman: 888-215-1999

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