Eyeworld

62 | EYEWORLD | APRIL 2023 R EFRACTIVE by Karolinne Rocha, MD, PhD Refractive Editor I have the distinct plea- sure of greeting you in this issue of EyeWorld as the new Refractive Editor. I am currently serving as the Director of the Cornea & Refractive Surgery Department and Fellowship Director at the Medical University of South Car- olina, Storm Eye Institute. I'd like to send my sincere gratitude to my predecessor in this role, Vance Thompson, MD, for his warm welcome and years of diligent leadership and insightful commentary in the field of refractive surgery. It's my honor to take the baton from you. Dr. Thompson has not gone far. In addition to serving on the EyeWorld Editorial Board, he is giving the Steinert Lecture at the 2023 ASCRS Refractive Day, taking place on May 5. Dr. Thompson is one of a wealth of experts who are taking the stage for ASCRS Refractive Day, including Program Chairs Daniel Chang, MD, and Cathleen McCabe, MD. In this issue, Dagny Zhu, MD, shares her unique experience entering the field of re- fractive surgery. Events like ASCRS Refractive Day, instructional courses, resources from the American Academy of Ophthalmology, the International Society of Refractive Surgery, and other educational and training opportunities all support physicians in acquiring new skills as desired, whether you are a freshman oph- thalmologist looking to break into a specialty or seasoned physician looking to maintain or expand a skillset. Both ASCRS Refractive Day and this issue of EyeWorld take a deep dive into image quality. In "The role of preoperative 'IQ,'" George Waring IV, MD, and Julie Schallhorn, MD, share their insights into what Dr. Waring calls an "emerg- ing area of interest" in vision beyond Snellen acuity. The article brings to mind a 59-year- old, post-myopic LASIK patient who presented with complaints of blurry vision. Snellen acuity measured at 20/25 / 20/20. In addressing the patient's subjective classification of "blurry," the condition of their vision would need to be as- sessed with other measurements that play a role in visual quality, among them the tear film, lens density, light scatter, higher order aberrations, loss of contrast, loss of accommodation, vitre- ous opacities, etc. In this patient, Scheimpflug tomography showed increased lens density, and ray tracing revealed increased lens aberrations and decreased contrast. Advanced diagnostics helped to decide against corneal surgery (re- fractive enhancement) at that time. Understanding that patients may need a customized approach in order to meet the visual demands of their day-to-day lives is a theme that runs through "Mixing and matching IOLs." Cullen Ryburn, MD, and Blake Williamson, MD, share their thoughts in this article. Speaking with the patient to understand their desired outcome and designing a unique approach to fit that patient's lifestyle is a significant step to a positive outcome. A deep understanding of the technology, in addition to the patient's needs, is necessary to identify the appropriate pairing— or combination. As you read this issue and explore the opportunities at the ASCRS Annual Meeting, consider the ways one can maximize visual out- comes. Surgical techniques, technology, patient assessments, communication skills, and more can all play a part in addressing the needs of and providing exceptional visual quality for our patients. ASCRS Refractive Day will touch on many of these topics. I hope to see you there. Journey from image quality to quality vision Surgical techniques, technology, patient assessments, communication skills, and more can all play a part in addressing the needs of and providing exceptional visual quality for our patients.

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