Eyeworld

JUN 2013

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

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58 EW MEETING REPORTER Reporting from the 2013 ASCRS•ASOA Symposium & Congress, San Francisco Editors' note: This Meeting Reporter contains original reporting by the EyeWorld news team from the 2013 ASCRS•ASOA Symposium & Congress, San Francisco. June 2013 Reporting from the 2013 ASCRS•ASOA Symposium & Congress OIS sets sights on anterior segment innovations The second annual Ophthalmology Innovation Summit (OIS) at the 2013 ASCRS•ASOA Symposium & Congress combined industry, clinicians, and entrepreneurs to highlight innovations in anterior segment surgery. The half-day session featured talks on the impact of femtosecond lasers and intraoperative aberrometry, as well as microinvasive glaucoma surgery (MIGS). Co-chairman William J. Link, PhD, Menlo Park, Calif., gave a talk on the status and impact of innovation in the ophthalmic world, and said a key criteria driving innovation is that technology has to be real and useful. "Multiple venture firms care about ophthalmology and are investing in the space," Dr. Link said. "Innovation is directed where it is rewarded." In the refractive space, Dr. Link predicted that corneal inlays will spur innovation as well. This is the first time that there is alignment in the cataract, refractive, and glaucoma spaces. In a session on femtosecond laser cataract surgery, Stephen Slade, MD, Houston, said the premium channel is still growing, and he continues to be impressed with femtosecond technology. Shareef Mahdavi, SM2 Strategic, Pleasanton, Calif., predicted that the femtosecond penetration rate would continue its upward trajectory. He surveyed users and found that more than 75% were able to break even or better. "Laser cataract surgery has penetrated 2-3% of the U.S. market and is on the rise," he said. Both wavefront aberrometry and femtosecond lasers are doing well, Dr. Slade said. OIS panelists discuss femtosecond and wavefront aberrometry innovations. Source: EyeWorld "Considering how disruptive they are to the cataract surgeons, I think they're tracking very nicely. The aberrometer makes them think about refractions again, and the [laser] is a large, expensive piece of equipment." The panel also discussed possible future uses for femto phaco, including corneal applications and IOL designs. Microinvasive glaucoma surgery (MIGS) is opening up possibilities for more surgical options in less invasive ways, which could expand the market, altering the current treatment paradigm, physicians said. "The whole treatment paradigm is changing to something that would be a single surgery for all intervention that might completely free patients from taking eye drops," said Gil Kliman, MD, Menlo Park, Calif. "But this is a new way of thinking about things, and it's going to take a while for the market to get this." Cornea Day: Fuchs' and cataracts Two surgeons presented on whether or not protecting or replacing the endothelium in patients with Fuchs' dystrophy results in better visual outcomes at Cornea Day 2013. Francis S. Mah, MD, La Jolla, Calif., said among the reasons to perform cataract surgery separately from endothelial keratoplasty is that "it's faster, there's a faster recovery of best corrected visual acuity, it's less expensive, there are fewer postoperative follow-up visits, and no need for topical immunosuppression medication." He noted that in recent years, there's been a shift away from concentrating on a patient's numbers to concentrating on the density of the cataract, the ocular comorbidities, and the patient's signs and symptoms. Surgeons who perform cataract surgery alone need to protect the endothelium, but "there is no difference between a scleral or tunnel incision," and likewise, no difference in the kind of viscoelastic used. Bryan D. Ayres, MD, Philadelphia, countered that among the ad-

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